{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:55:58Z","timestamp":1782496558006,"version":"3.54.5"},"reference-count":17,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82301440"],"award-info":[{"award-number":["82301440"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007452","name":"WU JIEPING Medical Foundation","doi-asserted-by":"crossref","award":["320.6750.2023-08-1"],"award-info":[{"award-number":["320.6750.2023-08-1"]}],"id":[{"id":"10.13039\/100007452","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Clinical Research Center, Ministry of Science and Technology of China","award":["303-01-001-0272-03"],"award-info":[{"award-number":["303-01-001-0272-03"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,29]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Postoperative acute pain following video-assisted thoracoscopic surgery (VATS) impedes patient rehabilitation. While multimodal analgesia effectively mitigates postoperative acute pain and facilitates the postoperative rehabilitation process, the efficacy of preventive precision multimodal analgesia (PPMA) remains uncertain. This study designs a PPMA strategy targeting incisional pain, inflammatory pain and visceral pain in VATS. It aims to investigate the impact of the PPMA strategy on the postoperative acute pain process and rehabilitation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method and analysis<\/jats:title>\n                    <jats:p>\n                      This multicentre, single-blinded, randomised controlled trial will enrol adult patients scheduled for elective thoracoscopic lobectomy or segmentectomy. A total of 1372 participants will be recruited and randomly allocated in a 1:1 ratio to either the preventive precision multimodal analgesia group (PPMA Group) or the conventional multimodal analgesia group (CMA Group). Patients in the PPMA Group will receive a regimen consisting of local anaesthetic infiltration of surgical incision (for incisional pain), intravenous injection of oxycodone (for visceral pain) and parecoxib sodium (for inflammatory pain) before surgery initiation. Patients in the CMA Group will receive the same regimen after specimen isolation. This trial will be conducted across 13 medical centres in China from 2023 to 2026. The primary outcome is the duration of postoperative acute pain. Secondary outcomes include postoperative analgesic consumption, postoperative pain scores, intraoperative haemodynamic parameters and the Indexes of Consciousness (IoC\n                      <jats:sub>1<\/jats:sub>\n                      and IoC\n                      <jats:sub>2<\/jats:sub>\n                      ), as well as intraoperative arterial blood gas and ventilation parameters, intraoperative dosages of general anaesthesia, inflammatory markers at predefined time points, postoperative rehabilitation process and perioperative adverse events and complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study has been approved by the Ethics Committee of Xuanwu Hospital, Capital Medical University (Linyanshen[2023]-NO.012-003-Revised Vision 1). The results will be published in a peer-reviewed journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>Chinese Clinical Trial Registry (ChiCTR2300072176).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-112197","type":"journal-article","created":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T18:35:20Z","timestamp":1771785320000},"page":"e112197","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of preventive precision multimodal analgesia (PPMA) on postoperative acute pain process and rehabilitation in adult patients undergoing thoracoscopic pulmonary resection: protocol for a prospective, multicentre, randomised controlled study"],"prefix":"10.1136","volume":"16","author":[{"given":"Zhen","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiping","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Operative Medicine, Medical Center of Anesthesiology and Pain, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Peking University International Hospital, Beijing, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longyun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospita, Taiyuan, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First People\u2019s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Northern Jiangsu People\u2019s Hospital Affiliated to Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China"},{"name":"Yangzhou Key Laboratory of Anaesthesiology, Yangzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Northern Jiangsu 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