• Xuru Wang, Xiaoyu Jia, Zhenping Li, and Qinghe Zhou.
• From the Department of Anaesthesiology and Pain Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China (XW, XJ, ZL, QZ).
• Eur J Anaesthesiol. 2023 Sep 1; 40 (9): 652659652-659.

BackgroundThe analgesic characteristics of rhomboid intercostal block (RIB) remain unclear. Before it can be fully recommended, we compared the recovery quality and analgesic effects of RIB and thoracic paravertebral block (TPVB) for video-assisted thoracoscopic surgery (VATS).ObjectiveThe current study aimed to investigate whether there is a difference in postoperative recovery quality between TPVB and RIB.DesignA prospective, non-inferiority, randomised controlled trial.SettingAffiliated Hospital of Jiaxing University in China from March 2021 to August 2022.PatientsEighty patients aged 18 to 80 years, with ASA physical status I to III, and scheduled for elective VATS were enrolled in the trial.InterventionUltrasound-guided TPVB or RIB was performed with 20 ml 0.375% ropivacaine.Main Outcome MeasuresThe primary outcome of the study was the mean difference of quality of recovery-40 scores 24 h postoperatively. The non-inferiority margin was defined as 6.3. Numeric rating scores (NRS) for pain at 0.5, 1, 3, 6, 12, 24 and 48 h postoperatively in all patients were also recorded.ResultsA total of 75 participants completed the study. The mean difference of quality of recovery-40 scores 24 h postoperatively was -1.6 (95% CI, -4.5 to 1.3), demonstrating the non-inferiority of RIB to TPVB. There was no significant difference between the two groups in the area under the curve for pain NRS over time, at rest and on movement, at 6, 12, 24 and 48 h postoperatively (all P  > 0.05), except for the area under the curve pain NRS over time on movement at 48 h postoperatively ( P  = 0.046). There were no statistical differences between the two groups in the postoperative sufentanil use at 0 to 24 h or 24 to 48 h (all P  > 0.05).ConclusionOur study suggests that RIB was non-inferior to TPVB for the quality of recovery, with almost the same postoperative analgesic effect as TPVB after VATS.Clinical Trial Registrationchictr.org.cn: ChiCTR2100043841.Copyright © 2023 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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