Continuous Rhomboid Intercostal Block for Thoracoscopic Postoperative Analgesia

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Pain Management

Background:

• Rhomboid intercostal block is a regional anesthesia technique.
• It is used for postoperative pain relief following video-assisted thoracoscopic surgery (VATS).
• Optimizing analgesia is crucial for recovery after VATS.

Purpose of the Study:

• To evaluate the efficacy of ultrasound-guided continuous rhomboid intercostal block (CRIB).
• To compare CRIB with patient-controlled intravenous analgesia for postoperative pain management.
• To assess the impact on the Quality of Recovery (QoR-40) scores after VATS.

Main Methods:

• Prospective randomized controlled trial involving 66 adult patients undergoing VATS.
• Patients were randomized to receive either standard analgesia (Group C) or CRIB with ropivacaine (Group CRIB).
• Quality of Recovery (QoR-40) scores and numeric rating scale (NRS) pain scores were recorded postoperatively.

Main Results:

• Group CRIB demonstrated significantly higher QoR-40 scores at 24 hours post-operation (172.6 ± 6.3) compared to Group C (155.4 ± 6.1).
• Patients receiving CRIB reported significantly lower NRS pain scores at rest and during movement up to 36 hours post-operation.
• The mean difference in QoR-40 scores favored CRIB by -17.2 points (95% CI, -20.4 to -13.9).

Conclusions:

• Ultrasound-guided continuous rhomboid intercostal block significantly improves the quality of recovery after VATS.
• CRIB provides superior postoperative analgesia compared to standard intravenous patient-controlled analgesia.
• This technique is effective for managing pain and enhancing recovery in VATS patients.