The effect of ultrasound-guided intercostal nerve block on postoperative analgesia in thoracoscopic surgery: A randomized, double-blinded, clinical trial

Background: Multimodal analgesia is accepted perioperative, intercostal nerve block (ICNB) which use ropivacaine is a kind of methods of multimodal analgesia. We aimed to explore the effect of ultrasound-guided intercostal nerve block on postoperative analgesia in thoracoscopic surgery . Methods: : Patients undergoing thoracoscopic pulmonary resection were randomized to receive either intercostal nerve block (ICNB) or not under ultrasound-guidance with ropivacaine prior to surgery. Visual analog scale pain scores at rest at 0,4, 8,16,24,48,72 and 168h postoperatively, surgical outcomes and rescue analgesia requirement were also recorded. Results: : VAS scores were statistically significantly lower for ICNB group compared to control group at 0, 4, 8, 16, 24 and 48h postoperatively. The duration of insertion of chest tube in ICBN group was shorter than that in control group, and the difference was statistically significant (4.69±2.14 vs 5.67±2.86, P =0.036). The postoperative hospital stay, incidence of nausea and vomiting and postoperative pulmonary infection rate in ICBN group were all lower than those in the control group, but there were no statistical differences. The frequency of rescue analgesia during 48 postoperative hours was different between the two groups (ICNB vs Control; 9.83% vs 31.03%, P =0.004). Conclusions: : For patients undergoing thoracoscopic surgery, ultrasound-guided ICNB is simple, safe, and effective for providing acute postoperative pain management during the early postoperative stage. Trial registration: Chinese clinical trials: chictr.org.cn, ChiCTR1900021017. Registred on 25/01/2019.