Ultrasound-guided paravertebral block with liposomal bupivacaine vs. non-liposomal bupivacaine for postoperative pain control after the Nuss procedure in children: A randomized clinical trial
Abstract
STUDY OBJECTIVE
Minimally invasive repair of pectus excavatum (Nuss procedure) is associated with significant postoperative pain and high-dose opioid consumption. Liposomal bupivacaine (LB), as an ultra-long-acting local anesthetic, has been extensively studied for perioperative analgesia. However, data regarding the effects of LB on postoperative pain in children undergoing the Nuss procedure remain limited. The aim of this study was to evaluate the ability of LB to reduce postoperative opioid use among children undergoing the Nuss procedure.
DESIGN
Randomized controlled trial.
SETTING
Operating room.
PATIENTS
Children aged 6-18 years who were scheduled for elective Nuss procedures.
INTERVENTIONS
Patients were randomly assigned to receive ultrasound-guided paravertebral block with either LB or non-liposomal bupivacaine (nLB) after anesthesia induction.
MEASUREMENTS
The primary outcome was the consumption of morphine equivalent during the first 72 h after surgery. The secondary endpoints included the maximum Numerical Rating Scale (NRS) pain score within 72 h, incidence of moderate-to-severe pain within 72 h, incidence of rebound pain within 72 h, NRS sleep score at 3 days, incidence of postoperative nausea and vomiting, length of hospital stay after surgery, and time to first ambulation after the operation.
MAIN RESULTS
A total of 109 subjects were included in the intention-to-treat analysis. Within 72 h after surgery, the morphine equivalent consumption in the LB group was…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 109 participants or records.
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