Effects of rhomboid intercostal plane block for postoperative analgesia after thoracoscopic surgery compared with local anesthetic infiltration: A randomized clinical trial

Background
The efficacy of pain control is a crucial element of improved recovery following thoracic surgery. Inadequate analgesia may extend the interval of hospitalization, besides raising medical costs. Fascial plane blocks are quickly becoming a feasible as well as a safe alternative to epidural analgesia for abdominal and thoracic pain. Rhomboid intercostal block (RIB) is a novel, simple block utilized in a region that is described as a triangle of auscultation on the scapula’s medial edge. This study attempted to determine the impact of RIB on postoperative pain following thoracoscopic surgery compared to local anesthetic (LA) infiltration.
Methods
The current research is a randomized, controlled trial on 60 subjects undergoing video-assisted thoracic surgery. Participants were randomly divided into two groups. All subjects received standard general anesthesia protocol, which included the insertion of a double-lumen endotracheal tube as well as mechanical ventilation. At the end of the operation in the RIB group, an injection of 20 ml bupivacaine (0.25%) was administered below the rhomboid major muscle guided by ultrasound. In the LA group, patients received local wound infiltration. Visual analog scores for pain during coughing and at rest, total postoperative analgesic consumption, adverse effects, and hospital stay were recorded.
Results
The study group demonstrated diminished visual analog scores during coughing as well as at rest with less overall consumption of analgesia compared to the local infiltration group.
Conclusion
Our study showed that ultrasound guided RIB provides better pain relief and less postoperative opioid consumption after thoracoscopic surgeries compared to local anesthetic infiltration.