Abstract 595P
Background
The purpose of this study was to evaluate whether using intercostal nerve block with a cocktail of analgesics, wherein ropivacaine is mixed with dexmedetomidine, dexamethasone, methylprednisolone, magnesium sulfate, and sodium bicarbonate, during thoracoscopic surgery results in better clinical outcomes than using ropivacaine alone.
Methods
Data from patients undergoing video-assisted thoracoscopic surgery (VATS) were consecutively collected between January 2023 and September 2023. The groups were randomized into two subgroups, which were cocktail intercostal nerve block group (CINB group) and ropivacaine intercostal nerve block group (RINB group). We assessed the patients' pain at different time points after surgery and discharge using the visual analog scale (VAS) and opioid consumption (morphine milligram equivalent, MME).
Results
After screening, 105 patients were randomized into two groups. The VAS scores were significantly lower in the CINB group than in the RINB group at 12 (3.00±0.99 vs. 3.66±0.85, p=0.001), 24 (2.60±0.85 vs. 3.66±0.85, p<0.001), and 48 2.26±0.75 vs. 4.02±0.84, p<0.001) hours. As for VAS after discharge, The VAS scores were all significantly lower in CINB group compared with RINB group 7 days (0.44±0.54 vs. 2.12±0.56, p<0.001), 14 days (0.14±0.35 vs. 1.37±0.60, p<0.001), and 30 days (0.08±0.27 vs. 0.78±0.42, p<0.001) after discharge. Postoperative opioid use was significantly lower in patients who underwent CINB (median = 0 MME, IQR 0–30 MME) compared to the RINB group (median = 30 MME, IQR 0–90 MME; p<0.001).
Conclusions
Based on this single-center analysis, CINB provided better analgesia after surgery and discharge, and reduced opioid consumption.
Clinical trial identification
The study was approved by the Chinese Clinical Trial Registry (ChiCTR2100046774). In accordance with the Declaration of Helsinki, the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University, and the Chinese Ethics Committee of Registering Clinical Trials approved our clinical research protocol (#357) in April 2021. Patients were informed of the risks associated with narcotic drug use and signed a formal informed consent form and provided informed written consent for the publication of their study data.
Editorial acknowledgement
Legal entity responsible for the study
Y. Dong.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.