Postoperative pain is very pronounced in patients with posterior lateral thoracotomy, which often leads to distress and is not conducive to postoperative coughing, leading to retention of upper respiratory secretions and increasing the risk of postoperative pulmonary tensions and pneumonia. In addition, postoperative pain prevents patients from getting out of bed early, increasing the risk of postoperative thrombosis. Epidural analgesia (EPI) has long been the gold standard for preventing postoperative pain, but there are side effects such as hypotension, urinary retention, itching, nausea, and intraspinal hematoma or epidural abscess. Recently, some thoracic surgeons have used liposomal bupivacaine to seal multiple intercostal nerve blocks (IB) during open chest. It is not clear whether the analgesic efficacy of IB is comparable to that of conventional EPI and whether the side effects of EPI can be avoided. In view of this, Prof. Khalil et al. conducted a retrospective study, the results of which were recently published in Ann Thorac Surg. The study retrospectively analyzed 85 patients who underwent open-heart surgery for lung, pleural, or mediastinal lesions between March 2010 and December 2013. Clinical variables, pain scores, use of additional analgesics, postoperative pulmonary complications and days of hospitalization were compared between the EPI and IB groups. The study included 53 patients in the IB group and 32 patients in the EPI group. The results showed that there was a significant difference in pain scores between the two groups on days 1 and 3, with patients in the ?IB group being significantly better than those in the EPI group, but there was no significant difference in pain scores on day 2; there was a significant reduction in pulmonary complications in the patients in the ?IB group (4/53) compared with those in the ?EPI group (8/32); and there was a significant difference in the mean length of hospitalization between the IB group and the EPI group, which was 7.4 days compared with 9.3 days. This study demonstrated that intraoperative use of multiple IBs with long-acting liposomal bupivacaine improved pain control on days 1 and 3 after open-heart surgery compared with EPI. This technique is simple, safe, and reproducible compared to EPI and does not require epidural infiltration, infusion pumps, or other measures to improve postoperative pain. Also this analgesic regimen may help to reduce postoperative pulmonary complications and shorten hospital stay. Currently, intercostal nerve block is mainly used for thoracic surgeries, including radical lung cancer surgery, alveolar resection, rib fracture, chest wall contusion, and yoke chest. This protocol significantly reduces patients’ postoperative pain, has low complications, is simple to perform, and will be increasingly favored by thoracic surgeons.