The impact of liposomal bupivacaine erector spinae plane block on postoperative analgesia and early functional recovery in patients undergoing thoracoscopic lung cancer surgery

Objectives This study aimed to evaluate the impact of liposomal bupivacaine erector spinae plane block (ESPB) on postoperative analgesia and early functional recovery in patients undergoing thoracoscopic lung cancer surgery. Methods A retrospective analysis was conducted on 246 patients who underwent video-assisted thoracoscopic surgery (VATS) for lung cancer from January 2021 to December 2023. Patients were divided into two groups based on the type of local anesthetic used for ESPB: bupivacaine (n=115) and liposomal bupivacaine (n=131). Postoperative pain levels, early functional recovery, opioid consumption, pulmonary function indices, perioperative adverse events, and other postoperative-related outcomes were assessed. Results Patients receiving liposomal bupivacaine reported lower pain scores at rest during the first 48 hours postoperatively compared to those receiving conventional bupivacaine. The liposomal bupivacaine group also demonstrated higher Quality of Recovery-15 (QoR-15) scores, reduced postoperative sufentanil consumption, and improved pulmonary function indices (FEV1 and FVC) throughout the observation period. Additionally, the time to first ambulation was shorter, and the time to the first request for analgesia was longer in the liposomal bupivacaine group (all P<0.05). No significant differences were observed in perioperative adverse events between the groups (P>0.05). Conclusions Liposomal bupivacaine ESPB is associated with improved postoperative analgesia and earlier functional recovery in patients undergoing VATS for lung cancer. These observed benefits may be attributed to the prolonged release profile of bupivacaine, which correlates with sustained pain relief and reduced opioid requirements. This technique holds promise for optimizing postoperative care and enhancing patient recovery following thoracic surgery.