Efficacy of Oxycodone Combined With Thoracic Paravertebral Nerve Block for Postoperative Analgesia in Esophageal Cancer Surgery: A Retrospective Study

Abstract

Background:

Thoracoscopic esophagectomy for esophageal cancer often results in substantial postoperative pain, which may impair recovery and increase the risk of complications. Effective and well-tolerated analgesia is essential to improve clinical outcomes.

Objective:

To evaluate the efficacy and safety of combining thoracic paravertebral nerve block (TPVB) with oxycodone-based intravenous patient-controlled analgesia (IV PCA) for postoperative pain management in patients undergoing thoracoscopic esophagectomy.

Methods:

A retrospective study was conducted from April 2022 to April 2023, including 160 patients undergoing thoracoscopic esophagectomy. Patients were divided into 4 groups: oxycodone IV PCA with TPVB (OT group), sufentanil IV PCA with TPVB (ST group), oxycodone IV PCA alone (O group), and sufentanil IV PCA alone (S group). Pain scores, opioid consumption, sedation levels, time to first mobilization, serum inflammatory markers (TNF-α, IL-6, IL-10), adverse events, and patient satisfaction were assessed and compared across groups.

Results:

OT group showed significantly lower pain scores at 12, 24, and 48 hours postoperatively (P < .01), along with reduced opioid consumption and fewer PCA attempts. Patients in the OT group mobilized earlier and reported higher satisfaction compared with the O and S groups. Inflammatory markers TNF-α and IL-6 were significantly lower, and IL-10 was higher in the OT group at 24 and 48 hours postoperatively, indicating a more favorable anti-inflammatory profile.

Conclusion and Relevance:

This study demonstrates that combining TPVB with oxycodone IV PCA provides superior analgesia, faster recovery, and better anti-inflammatory effects than sufentanil-based or single-modality regimens, with a low incidence of adverse events.

These findings highlight a clinically effective multimodal strategy for postoperative pain control in esophageal cancer surgery. Based on the data, this approach may reduce chronic pain and improve recovery quality, supporting its broader clinical application.