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Liposomal bupivacaine versus ropivacaine thoracic paravertebral block for thoracoscopic atrial septal defect repair: analgesic efficacy and cardiac biomarker outcomes in a single-center, assessor-blinded, randomized trial

   
@article{JTD125655,
	author = {Bingqian Li and Yuxin Gao and Jingjing Han and Yan Li and Yu Chen},
	title = {Liposomal bupivacaine versus ropivacaine thoracic paravertebral block for thoracoscopic atrial septal defect repair: analgesic efficacy and cardiac biomarker outcomes in a single-center, assessor-blinded, randomized trial},
	journal = {Journal of Thoracic Disease},
	volume = {0},
	number = {0},
	year = {2026},
	keywords = {},
	abstract = {Background: Thoracoscopic atrial septal defect (ASD) repair, although minimally invasive, can cause substantial postoperative pain. Thoracic paravertebral block (TPVB) provides effective chest wall analgesia, and liposomal bupivacaine (LB), a long-acting local anesthetic with sustained release, may prolong analgesic duration. We investigated whether ultrasound-guided TPVB using long-acting LB improves postoperative analgesia without compromising cardiovascular safety compared with ropivacaine (RP).Methods: This randomized, assessor-blinded trial enrolled 94 patients undergoing thoracoscopic ASD repair, who were randomly assigned (1:1) to receive ultrasound-guided TPVB with either LB or RP. Eligibility criteria included age 18–55 years, American Society of Anesthesiologists (ASA) II–III, New York Heart Association (NYHA) II–III, and ejection fraction (EF) >50%. Randomization was computer-generated with sealed envelopes. Safety monitoring included continuous electrocardiography (ECG) for arrhythmias, with Clavien-Dindo grading and Naranjo causality assessment. The primary endpoint was the numerical rating scale (NRS, 0–10) pain score during coughing at 24 h postoperatively. Secondary outcomes included NRS scores at other time points, 72-h opioid consumption (morphine milligram equivalents, MME), time to first rescue analgesia, extended analgesia outcomes [postoperative days 4–7 (POD4–POD7)], perioperative hemodynamics, postoperative recovery, cardiac/inflammatory biomarker trajectories, and adverse events (with postoperative arrhythmias analyzed separately).Results: Baseline demographic, clinical, and intraoperative variables were well-balanced between groups (all P>0.05). Compared with RP, LB was associated with lower NRS pain scores at rest and during coughing from extubation through 72 h (all P},
	issn = {2077-6624},	url = {https://jtd.amegroups.org/article/view/125655}
}