Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission

Background and Aims Pleurectomy/decortication (P/D), for malignant pleural mesothelioma is maximally invasive surgeries, which causes the prolonged length of hospitalization after surgery. Previous studies reported that regional anesthesia in addition to general anesthesia likely contribute to shorten hospital stay after surgery with reduction of acute postoperative pain. Association between the continuous intertransverse process block for postoperative analgesia and the length of hospital stay after P/D, however, has not been evaluated. This study aims to evaluate the association between postoperative analgesia using continuous intertransverse process block and shorter postoperative stay after P/D.

Methods In a single-institutional observational study, adult patients undergoing P/D under general anesthesia with single-injection regional block, who received either continuous intertransverse process block or continuous intravenous (IV) fentanyl infusion after surgery for postoperative analgesia, were enrolled from March 2022 to February 2023. Multivariable logistic regression analysis was performed to determine the association between perioperative variables and length of hospital stay.

Results In all patients (n=60), postoperative analgesia was performed using either continuous intertransverse process block in patients (n=19) or continuous IV fentanyl infusion (n=41).The result revealed shorter length of hospital stay after surgery was significantly associated with continuous intertransverse process block (P=0.007). In subgroup analysis, Both C-reactive protein level on postoperative day (POD) 3 was lower (P=0.017), and postoperative pain on POD 3 was lower (P=0.045) in patients with continuous intertransverse process block.

Conclusions Postoperative analgesia using continuous intertransverse process block is likely associated with the reduction of the length of hospital stay after P/D under general anesthesia.