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Article Open Access

Efficacy of nerve blocks for postoperative analgesia in lung cancer: A meta‑analysis of randomized clinical trials

  • Authors:
    • Jie Wu
    • Yu-Xin Liu
    • Shipeng Zhang
    • Baiping An
  • View Affiliations / Copyright

    Affiliations: Acupuncture and Massage College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 61137, P.R. China, Department of Oncology and Hematology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100029, P.R. China, Department of Oncology II, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, P.R. China
    Copyright: © Wu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 44
    |
    Published online on: December 3, 2025
       https://doi.org/10.3892/etm.2025.13039
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Abstract

The management of postoperative pain in patients with lung cancer is a key factor affecting patient comfort and postoperative recovery. The aim of the present review was to compare regional block techniques with traditional analgesic methods, demonstrating their advantages in postoperative analgesia and facilitating patient recovery following thoracoscopic surgery. The effects of different regional analgesic techniques were systematically searched from establishment of the database to April 2024 in Web of Science, Embase and Cochrane. The search strategies were developed using the population, interventions, comparators, outcomes and study design framework, and the results are presented in accordance with the guidelines set out by the preferred reporting items for systematic reviews and meta‑analyses statement. The primary outcome was the visual analogue scale (VAS) score, with secondary outcomes including patient self‑administered intravenous analgesia, number of patients requiring additional injections of analgesic following surgery and the incidence of adverse reactions as outcome indicators. The present meta‑analysis included 14 randomized clinical trials with a total of 1,524 patients and four regional block techniques (paravertebral block, thoracic paravertebral block, serratus anterior plane block, intercostal nerve block). Based on limited evidence, regional block surgery was more effective at relieving postoperative pain and had a lower incidence of adverse reactions, but there was no significant difference in VAS scores between this group and the control group. Compared with the control group, five studies reported a significant decrease in the number of patients requiring additional painkillers following surgery in the group receiving nerve block (I2=14.9%). A total of seven studies showed a significant improvement in the use of patient‑controlled analgesia (I2=72.5%); seven studies showed a decrease in nausea and vomiting (I2=22.1%) and four studies reported significant improvement in lung function (I2=44.8%). Other adverse reactions included delirium, drowsiness, venous thrombosis and intestinal obstruction. The present results indicated a significant decrease in various other adverse side effects in the experimental group (I2=46.4%), and there was no notable publication bias. Compared with conventional anesthesia, nerve block techniques in pain management following thoracoscopic surgery for lung cancer decreased the patient‑controlled analgesia usage and the number of patients requiring additional postoperative analgesic, but the VAS scores remained inconsistent. In addition, nerve block technology had a lower incidence of postoperative complications and improved the quality of life of patients with cancer.
View Figures

Figure 1

Preferred Reporting Items for
Systematic Reviews and Meta-Analyses flow chart. WOS, Web of
Science.

Figure 2

Risk of bias. The overall quality of
the included studies was considered adequate. Green: Indicates low
bias risk Yellow: Indicates unclear bias risk Green: Indicates high
bias risk.

Figure 3

Visual analogue scale score after 24
h. Weights calculated from random effects analysis. CI, confidence
interval. SMD, standardized mean difference. PVB, paravertebral
block; TPVB, thoracic paravertebral space to block; SAPB, serratus
anterior plane block; ICNB, intercostal nerve block.

Figure 4

Visual analogue scale score after 48
h. CI, confidence interval; SMD, standardized mean difference; PVB,
paravertebral block; TPVB, thoracic paravertebral space to block;
SAPB, serratus anterior plane block.

Figure 5

Visual analogue scale score after 72
h. CI, confidence interval; SMD, standardized mean difference.

Figure 6

Number of individuals requiring
additional postoperative analgesic. CI, confidence interval; OR,
odds ratio.

Figure 7

Number of instances of
patient-controlled analgesia. CI, confidence interval; SMD,
standardized mean difference.

Figure 8

Number of instances of nausea and
vomiting. CI, confidence interval; OR, odds ratio.

Figure 9

Number of instances of pulmonary
adverse reactions. CI, confidence interval; OR, odds ratio.

Figure 10

Number of instances of other adverse
reactions. CI, confidence interval; OR, odds ratio.

Figure 11

Forest plot of the visual analogue
scale scores after 24 h. CI, confidence interval; SMD, standardized
mean difference; PVB, paravertebral block; TPVB, thoracic thoracic
paravertebral block; SAPB, serratus anterior plane block; ICNB,
intercostal nerve block via pleural cavity.

Figure 12

Forest plot of the visual analogue
scale scores after 48 h. CI, confidence interval; SMD, standardized
mean difference; PVB, paravertebral block; TPVB, thoracic
paravertebral block; SAPB, serratus anterior plane block; ICNB,
intercostal nerve block. For subgroups with one study only,
statistical heterogeneity (I² statistic) and its corresponding
P-value cannot be calculated, as these metrics need at least two
studies for between-study variance comparison.

Figure 13

Forest plot of the visual analogue
scale scores after 72 h. CI, confidence interval; SMD, standardized
mean difference; PVB, paravertebral block; TPVB, thoracic
paravertebral block; SAPB, serratus anterior plane block; ICNB,
intercostal nerve block.

Figure 14

Funnel plot of the visual analogue
scale scores after 24 h. se(SMD), standard error of SMD; SMD,
standardized mean difference.

Figure 15

Funnel plot of the visual analogue
scale scores after 48 h. se(SMD), standard error of SMD; SMD,
standardized mean difference.

Figure 16

Funnel plot of the visual analogue
scale scores after 72 h. se(SMD), standard error of SMD; SMD,
standardized mean difference.
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Copy and paste a formatted citation
Spandidos Publications style
Wu J, Liu Y, Zhang S and An B: Efficacy of nerve blocks for postoperative analgesia in lung cancer: A meta‑analysis of randomized clinical trials. Exp Ther Med 31: 44, 2026.
APA
Wu, J., Liu, Y., Zhang, S., & An, B. (2026). Efficacy of nerve blocks for postoperative analgesia in lung cancer: A meta‑analysis of randomized clinical trials. Experimental and Therapeutic Medicine, 31, 44. https://doi.org/10.3892/etm.2025.13039
MLA
Wu, J., Liu, Y., Zhang, S., An, B."Efficacy of nerve blocks for postoperative analgesia in lung cancer: A meta‑analysis of randomized clinical trials". Experimental and Therapeutic Medicine 31.2 (2026): 44.
Chicago
Wu, J., Liu, Y., Zhang, S., An, B."Efficacy of nerve blocks for postoperative analgesia in lung cancer: A meta‑analysis of randomized clinical trials". Experimental and Therapeutic Medicine 31, no. 2 (2026): 44. https://doi.org/10.3892/etm.2025.13039
Copy and paste a formatted citation
x
Spandidos Publications style
Wu J, Liu Y, Zhang S and An B: Efficacy of nerve blocks for postoperative analgesia in lung cancer: A meta‑analysis of randomized clinical trials. Exp Ther Med 31: 44, 2026.
APA
Wu, J., Liu, Y., Zhang, S., & An, B. (2026). Efficacy of nerve blocks for postoperative analgesia in lung cancer: A meta‑analysis of randomized clinical trials. Experimental and Therapeutic Medicine, 31, 44. https://doi.org/10.3892/etm.2025.13039
MLA
Wu, J., Liu, Y., Zhang, S., An, B."Efficacy of nerve blocks for postoperative analgesia in lung cancer: A meta‑analysis of randomized clinical trials". Experimental and Therapeutic Medicine 31.2 (2026): 44.
Chicago
Wu, J., Liu, Y., Zhang, S., An, B."Efficacy of nerve blocks for postoperative analgesia in lung cancer: A meta‑analysis of randomized clinical trials". Experimental and Therapeutic Medicine 31, no. 2 (2026): 44. https://doi.org/10.3892/etm.2025.13039
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