Comparison of ultrasound-guided two-point block of the rhomboid intercostal <i>vs.</i> thoracic paravertebral for postoperative analgesia in patients undergoing three-port thoracoscopic surgery: a prospective, randomized, non-inferiority study.
Ultrasound-guided two-point rhomboid intercostal block is non-inferior to thoracic paravertebral block for postoperative analgesia in thoracoscopic surgery, but may require more rescue analgesia.
Where it sits
this study against the rest of the teriparatide (pth 1-34) corpusSummary and findings
This study compared the analgesic efficacy of ultrasound-guided two-point rhomboid intercostal block (RIB) with that of two-point thoracic paravertebral block (TPVB) in patients undergoing three-port thoracoscopic surgery. Seventy patients were block-randomized to receive either TPVB or RIB, both using 10 mL of 0.5% ropivacaine. The primary outcome was the numerical rating scale (NRS) pain score at rest 24 hours after surgery.
Abstract
<h4>Background</h4>The anesthetic characteristics of ultrasound-guided two-point rhomboid intercostal block (RIB) have not been fully established. This study compared the analgesic efficacy of ultrasound-guided two-point RIB with that of two-point thoracic paravertebral block (TPVB) for postoperative pain control and recovery in patients undergoing three-port thoracoscopic surgery.<h4>Methods</h4>Seventy patients aged 18-80 years scheduled for three-port thoracoscopic pulmonary resection were block-randomized in a 1:1 ratio to receive either TPVB or RIB. Both techniques were performed using 10 mL of 0.5% ropivacaine at each injection site. The primary outcome was the numerical rating scale (NRS) pain score at rest 24 h after surgery, with a predefined non-inferiority margin of Δ = 1. Secondary outcomes included NRS at rest and during coughing at 0.5, 2, 4, 12, 18, 24, and 48 h postoperatively, as well as the 24h postoperative Quality of Recovery-40 (QoR-40) score.<h4>Results</h4>The final analysis included 34 patients in the TPVB group and 34 in the RIB group. The mean difference in resting NRS scores at 24 h between the two groups was 0.088 (95% CI, -0.377 to 0.553), confirming the non-inferiority of RIB. However, the need for rescue analgesia was numerically greater in the RIB group than in the TPVB group (<i>p</i> = 0.045). The 24-h postoperative QoR-40 scores and cumulative sufentanil consumption within 48 h after surgery were comparable between the groups (both <i>p</i> > 0.05).<h4>Conclusion</h4>Ultrasound-guided two-point RIB provided postoperative analgesia that was non-inferior to TPVB in patients undergoing three-port thoracoscopic surgery.