AUTHOR=Deng Wei , Jiang Chen-Wei , Qian Ke-jian , Liu Fen 

TITLE=Evaluation of Rhomboid Intercostal Block in Video-Assisted Thoracic Surgery: Comparing Three Concentrations of Ropivacaine

JOURNAL=Frontiers in Pharmacology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.774859

DOI=10.3389/fphar.2021.774859

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> Ultrasound-guided rhombic intercostal block (RIB) is a novel regional block that provides analgesia for patients who have received video-assisted thoracoscopic surgery (VATS). The anesthetic characteristics of ultrasound-guided RIB with different concentrations of ropivacaine are not known. This research primarily hypothesizes that ultrasound-guided RIB, given in combination with the same volume of different concentrations of ropivacaine, would improve the whole quality of recovery-40 (QoR-40) among patients with VATS.</p><p><bold>Approaches</bold>: This double-blinded, single-center, prospective, and controlled trial randomized 100 patients undergoing VATS to receive RIB. One hundred patients who have received elective VATS and satisfied inclusion standards were fallen into four groups randomly: control group with no RIB and R<sub>0.2%</sub>, R<sub>0.3%</sub>, and R<sub>0.4%</sub>; they underwent common anesthesia plus the RIB with ropivacaine at 0.2%, 0.3%, and 0.4% in a volume of 30 ml.</p><p><bold>Outcomes:</bold> Groups R<sub>0.2%</sub>, R<sub>0.3%</sub>, and R<sub>0.4%</sub> displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the control group (Group C) (<italic>p</italic> &lt; 0.001 for all contrasts). Groups R<sub>0.3%</sub> and R<sub>0.4%</sub> displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the R<sub>0.2%</sub> group (<italic>p</italic> &lt; 0.001 for all contrasts). The overall QoR-40 scores and QoR-40 dimensions [physical comfort (<italic>p</italic> = 0.585)] did not vary greatly between Groups R<sub>0.3%</sub> and R<sub>0.4%</sub> (<italic>p</italic> &gt; 0.05 for all contrasts). Groups R<sub>0.2%</sub>, R<sub>0.3%</sub>, and R<sub>0.4%</sub> showed significant differences in numerical rating scales (NRS) score region under the curve (AUC) at rest and on movement in 48 h when compared with the Group C (<italic>p</italic> &lt; 0.001 for all contrasts). Groups R<sub>0.3%</sub> and R<sub>0.4%</sub> displayed great diversities in NRS score AUC at rest and on movement in 48 h when compared with the R<sub>0.2%</sub> group (<italic>p</italic> &lt; 0.001 for all contrasts). The NRS mark AUC at rest and, on movement in 48 h, did not vary greatly between the Group R<sub>0.3%</sub> and R<sub>0.4%</sub> (<italic>p</italic> &gt; 0.05 for all contrasts).</p><p><bold>Conclusion:</bold> In this study it was found that a dose of 0.3% ropivacaine is the best concentration for RIB for patients undergoing VATS. Through growing ropivacaine concentration, the analgesia of the RIB was not improved greatly.</p><p><bold>Clinicaltrials.gov Registration:</bold><ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov/</ext-link>, identifier ChiCTR2100046254.</p>