Effect of adding preoperative serratus anterior plane block to intercostal nerve block with liposomal bupivacaine on postoperative pain in patients undergoing video-assisted thoracoscopic lung resection: study protocol for a prospective randomized controlled trial
- 1Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- 2Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Abstract
Background: Effective postoperative pain management is fundamental to enhanced recovery after video-assisted thoracoscopic surgery (VATS). Previous studies have demonstrated that both serratus anterior plane block (SAPB) and intercostal nerve block (ICNB) effectively alleviate postoperative pain. However, data on the combination of these two techniques using liposomal bupivacaine, a sustained-release local anesthetic formulation, remain limited. Accordingly, this randomized controlled trial aims to compare the postoperative analgesic efficacy of combined preoperative SAPB and intraoperative ICNB vs. sham SAPB plus active ICNB in patients undergoing VATS lung resection, with liposomal bupivacaine administered for both blocks.
Methods: This single-center randomized controlled trial will enroll 98 patients scheduled for video-assisted thoracoscopic lung resection to compare the postoperative analgesic efficacy of combined preoperative SAPB and intraoperative ICNB vs. sham SAPB plus intraoperative ICNB, with liposomal bupivacaine administered for both nerve blocks. The primary outcome is the VAS (0–10) pain score with movement at 24 h postoperatively; secondary outcomes include cumulative sufentanil consumption within 48 h and the number of patient-controlled intravenous analgesia (PCIA) demands.
Discussion: This trial will provide the first head-to-head evidence comparing the analgesic efficacy of combined SAPB and ICNB vs. sham SAPB plus ICNB using liposomal bupivacaine in VATS lung resection. If the combination strategy demonstrates superior analgesic efficacy, it may establish a more effective multimodal analgesic regimen for postoperative pain management in thoracic surgery. These findings are expected to inform clinical practice and guide the development of future perioperative analgesic protocols.
Clinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=295245, identifier ChiCTR2500112224.
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BibTeX
@article{liang2026effect,
title = {{Effect of adding preoperative serratus anterior plane block to intercostal nerve block with liposomal bupivacaine on postoperative pain in patients undergoing video-assisted thoracoscopic lung resection: study protocol for a prospective randomized controlled trial}},
author = {Huiqiu Liang and Qin Cui and Qun Wang and Hongzhang Ding and Yu Zhou and Zhikai Ling and Maolin Ran and Lijun Tang},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1948798},
url = {https://doi.org/10.3389/fmed.2026.1948798},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effect of adding preoperative serratus anterior plane block to intercostal nerve block with liposomal bupivacaine on postoperative pain in patients undergoing video-assisted thoracoscopic lung resection: study protocol for a prospective randomized controlled trial
AU - Huiqiu Liang
AU - Qin Cui
AU - Qun Wang
AU - Hongzhang Ding
AU - Yu Zhou
AU - Zhikai Ling
AU - Maolin Ran
AU - Lijun Tang
PY - 2026
DA - 2026/10/13
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1948798
UR - https://doi.org/10.3389/fmed.2026.1948798
AB - Background: Effective postoperative pain management is fundamental to enhanced recovery after video-assisted thoracoscopic surgery (VATS). Previous studies have demonstrated that both serratus anterior plane block (SAPB) and intercostal nerve block (ICNB) effectively alleviate postoperative pain. However, data on the combination of these two techniques using liposomal bupivacaine, a sustained-release local anesthetic formulation, remain limited. Accordingly, this randomized controlled trial aims to compare the postoperative analgesic efficacy of combined preoperative SAPB and intraoperative ICNB vs. sham SAPB plus active ICNB in patients undergoing VATS lung resection, with liposomal bupivacaine administered for both blocks. Methods: This single-center randomized controlled trial will enroll 98 patients scheduled for video-assisted thoracoscopic lung resection to compare the postoperative analgesic efficacy of combined preoperative SAPB and intraoperative ICNB vs. sham SAPB plus intraoperative ICNB, with liposomal bupivacaine administered for both nerve blocks. The primary outcome is the VAS (0–10) pain score with movement at 24 h postoperatively; secondary outcomes include cumulative sufentanil consumption within 48 h and the number of patient-controlled intravenous analgesia (PCIA) demands. Discussion: This trial will provide the first head-to-head evidence comparing the analgesic efficacy of combined SAPB and ICNB vs. sham SAPB plus ICNB using liposomal bupivacaine in VATS lung resection. If the combination strategy demonstrates superior analgesic efficacy, it may establish a more effective multimodal analgesic regimen for postoperative pain management in thoracic surgery. These findings are expected to inform clinical practice and guide the development of future perioperative analgesic protocols. Clinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=295245, identifier ChiCTR2500112224.
SN - 2296-858X
ER -