Postoperative Analgesic Impacts of Ultrasound-Guided Intercostal Nerve Block with Different Concentrations of Ropivacaine in Combination with General Anesthesia for Patients Undergoing Thoracoscopic Surgery

Abstract

Background: Postoperative pain is the most common complication following thoracoscopic surgery (TS). Ropivacaine is a commonly used analgesic drug in clinical settings. This study aims to explore the analgesic effects of ultrasound-guided intercostal nerve block (INB) with different concentrations of ropivacaine during postoperative pain management in patients undergoing TS. Methods: This prospective, randomized, and controlled trial included 100 study participants from May 2019 to May 2022. The patients were equally divided into the ropivacaine (0.5%, 0.25%), the blank, and the control groups. The 0.5% or 0.25% group received 0.5% or 0.25% ropivacaine injection (15 mL) under the induction of ultrasound. However, the blank group received a placebo injection (15 mL saline) under the induction of ultrasound. The control group was administered with a placebo injection (15 mL saline). Furthermore, baseline characteristics, numeric rating scale (NRS) score, Bruggrmann comfort scale (BCS) score, postoperative analgesic drug supplementation, and adverse events were analyzed across the four groups. Results: At rest or during movement, the NRS score initially increased and then gradually decreased across four groups. Moreover, 12-, 24-, or 36-hour post-surgery, NRS score was significantly reduced in the 0.5% ropivacaine group relative to the 0.25% ropivacaine group. Furthermore, similar trend of NRS score was observed during movement. After surgery 48 h, the BCS score was significantly higher in the 0.5% or 0.25% ropivacaine group compared to the blank group. However, the BCS score was found to be higher in the 0.5% ropivacaine group compared to the 0.25% ropivacaine group. The number of patients with postoperative analgesic drug supplementation was significantly reduced in the 0.5% or 0.25% ropivacaine group than in the blank group (3 or 6 cases vs. 16 cases, p < 0.001). Conclusions: In summary, 0.5% ropivacaine for INB under ultrasound guidance exhibited a better postoperative analgesic effect for patients undergoing TS, offering a theoretical basis for clinical applications.