Effect of Intercostal Nerve Block With Liposomal Bupivacaine on Quality of Recovery in VATS Partial Pneumonectomy

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach for partial pneumonectomy, but postoperative pain remains a major challenge affecting recovery. Intercostal nerve block (ICNB) with conventional local anesthetics provides limited duration of analgesia, often insufficient to cover the peak pain period after surgery. Liposomal bupivacaine is a long-acting formulation designed to provide extended analgesia up to 72 hours. This study aims to evaluate the effect of preoperative ICNB with liposomal bupivacaine compared with conventional bupivacaine hydrochloride on postoperative quality of recovery in patients undergoing VATS partial pneumonectomy. The primary outcome is the Quality of Recovery-15 (QoR-15) score at 24 hours postoperatively. We hypothesize that liposomal bupivacaine ICNB results in superior recovery quality compared with conventional bupivacaine, with reduced postoperative pain and opioid consumption.

Inclusion Criteria: * Patients scheduled for thoracic surgery under general anesthesia via thoracoscopic approach; * Age 18-65 years; * Classified as Grade I-II by the American Society of Anesthesiologists (ASA). Exclusion Criteria: * History of local anesthetic allergy. * Chronic opioid users. * Contraindications for nerve block, including infection at the puncture site and coagulation disorders; * Language communication impairment. * Other conditions unsuitable for inclusion in the trial.