Evidence map›Paper›PMID 40758210›Full record

ArticlePain and therapy2025

Liposomal Bupivacaine vs. Plain Bupivacaine with Dexamethasone for Rhomboid Intercostal Block in the Management of Postoperative Pain After Video-Assisted Thoracoscopic Surgery: A Randomized Non-inferiority Trial.

Lei Xie, Yazhi Xi, Xinyao He, Mingzi An, Xiaoyu Jia, Zhenping Li, Tao Chen, Qinghe Zhou

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06392191 (Effects of Liposomal Bupivacaine Combined With Bupivacaine and Dexamethasone for Rhomboid Intercostal Block on Postoperative Pain Following Video-Assisted Thoracoscopic Surgery), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06392191 nacompletednot on this map

Effects of Liposomal Bupivacaine Combined With Bupivacaine and Dexamethasone for Rhomboid Intercostal Block on Postoperative Pain Following Video-Assisted Thoracoscopic Surgery: A Non-inferiority, Double-blind, Randomized Trial.

TypeinterventionalSponsorAffiliated Hospital of Jiaxing UniversityRan2024 to 2025Enrolled148ConditionsThoracic SurgeryArmsRhombic intercostal nerve block(Received liposomal bupivacaine 93 mg and bupivacaine 25 mg diluted to 20 ml), Rhombic intercostal nerve block(Receive standard bupivacaine 105 mg diluted to 20 ml with dexamethasone 5 mg.)
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lei Xie *Anesthesia Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Yazhi Xi *Anesthesia Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Xinyao HeAnesthesia Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Mingzi AnDepartment of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, No. 1882, South of the Second Ring Road, Jiaxing, Zhejiang, China.
Xiaoyu JiaDepartment of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, No. 1882, South of the Second Ring Road, Jiaxing, Zhejiang, China.
Zhenping LiDepartment of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, No. 1882, South of the Second Ring Road, Jiaxing, Zhejiang, China.
Tao Chen *Department of Anesthesiology, Tongxiang First People's Hospital, No. 1918, Jiaochang Road, Tongxiang, Zhejiang, China. goandjump@163.com.
Qinghe Zhou *Department of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, No. 1882, South of the Second Ring Road, Jiaxing, Zhejiang, China. zqh10980@zjxu.edu.cn.ORCID http://orcid.org/0000-0002-0731-6302

Funding

Guangdong Provincial Key Laboratory of Prevention and Control for Severe Clinical Animal Diseases 2023-ZJZK-001Jiaxing Key Discipline of Medicine-Anesthesiology 2023-ZC-001Medical Science and Technology Project of Zhejiang Province 2025KY375
6 · The paper itself

Abstract

introductionEffective and sustained postoperative analgesia is essential to enhance recovery after video-assisted thoracoscopic surgery (VATS). Liposomal bupivacaine, a multivesicular formulation enabling extended local anesthetic release, offers a mechanistic advantage over conventional agents. However, prior comparisons with adjuvant-enhanced regimens such as plain bupivacaine plus dexamethasone were confounded by pharmacological and dose inequivalence. This equivalence-dose randomized controlled trial evaluated whether liposomal bupivacaine provides non-inferior analgesia to the standard combination when administered via rhomboid intercostal block (RIB).

methodsIn this double-blind randomized controlled trial, 90 VATS patients were randomly assigned to receive either: a 20-ml premixed solution containing 93 mg of liposomal bupivacaine combined with 25 mg of plain bupivacaine (liposomal bupivacaine group), or a 20-ml admixture of 105 mg of plain bupivacaine and 5 mg of dexamethasone (plain bupivacaine with dexamethasone group). The primary outcome assessed was the area under the curve (AUC) of the 48-h resting pain numeric rating scale (NRS). Secondary outcomes consisted of opioid consumption, dermatomal spread, and Quality of Recovery-15 scores (QoR-15).

resultsLiposomal bupivacaine was shown to be non-inferior to plain bupivacaine with dexamethasone, with a 48-h NRS AUC of 105.5 ± 13.6 vs. 113.1 ± 16.3 (mean difference - 7.6; 95% CI - 13.9 to - 1.2, upper limit < non-inferiority margin 3.7). Opioid use and dermatomal spread were comparable within the first 24 h (P > 0.05). There was a notable contrast in sustained dermatome blockade at 48 and 72 h between the two groups (P < 0.001). The liposomal bupivacaine group demonstrated a significantly reduced opioid requirement (P = 0.016) within 24-48 h and superior QoR-15 scores on postoperative day 2 (POD2) (P < 0.001). Safety profiles were comparable, with no between-group differences in postoperative nausea and vomiting or other severe complications (P > 0.05).

conclusionsRhomboid intercostal block with liposomal bupivacaine provided similar analgesia to plain bupivacaine with dexamethasone for postoperative pain after VATS.

trial registrationThe trial was registered on ClinicalTrials.gov (NCT06392191). Graphical Abstract available in the Supplementary Materials for this article.

Indexed as

AnalgesiaLiposomal bupivacaineRhomboid intercostal blockVideo-assisted thoracoscopic surgery

Identifiers

PMID40758210
PMCPMC12484463

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.