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Opioid-free Anesthesia in VATS Lung Resection

Not Applicable
Conditions
Opioid Free Anesthesia
Interventions
Procedure: Paravertebral block+Anterior serratus plane block
Drug: opioid free anesthesia
Drug: opioid based anesthesia
Registration Number
NCT04507165
Lead Sponsor
Peking University People's Hospital
Brief Summary

A comparison of incidences of postoperative opioid-related adverse effects and recovery parameters in patients undergoing video-assisted thoracoscopic surgery (VATS) lung resection receiving opioid or opioid-free general anesthesia (OFA).

Detailed Description

Video-assisted thoracoscopic surgery (VATS) lung resection is traditionally performed under general anesthesia with opioid-based analgesia. It is associated with higher incidences of respiratory depression, hypotension, postoperative nausea and vomiting (PONV), dizziness, constipation and urinary retention, and more severe acute postoperative pain.

The purpose of our study is to compare the opioid-free general anesthesia with the opioid-based general anesthesia with respect to the primary outcome measures of the total incidence of opioid-related adverse effects (including respiratory depression, hypotension, PONV and dizziness) and secondary outcome measures of incidence of intraoperative and postoperative cardiovascular complications, pain relief, analgesic requirement , and other postoperative recovery parameters \[e.g. duration of tracheal extubation, departing from post-anaesthesia care unit (PACU), exhaust, defecation, and stay in hospital postoperatively\].

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Undergoing VATS lung resection.
  • American Society of Anesthesiologists (ASA) physical status I-II.
  • Agreed to participate in the trial.
Exclusion Criteria
  • Pregnant women
  • ASA phase III or above.
  • Undergoing emergency surgery.
  • Planning for thoracotomy.
  • Adults protected by law (under judicial protection, guardianship or supervision), people who deprived of their liberty.
  • Patients who have received general anesthesia.
  • Atrioventricular block, sinus node block or intraventricular block.
  • Sinus bradycardia (heart rate is less than 60 beats/min).
  • Preoperative hypotension (systolic blood pressure is less than 90mmHg)
  • Combined with urolithiasis, Meniere syndrome, and vertebral artery stenosis
  • Combined with cerebrovascular disease.
  • Contraindication to NSAIDs drug.
  • Allergic to anesthetics.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
opioid-free general anesthesiaParavertebral block+Anterior serratus plane blockunder opioid-free general anesthesia
opioid-free general anesthesiaopioid free anesthesiaunder opioid-free general anesthesia
opioid based general anesthesiaParavertebral block+Anterior serratus plane blockunder opioid based general anesthesia
opioid based general anesthesiaopioid based anesthesiaunder opioid based general anesthesia
Primary Outcome Measures
NameTimeMethod
Total incidence of opioid-related adverse effects of 2 hours, 4 hours, 6 hours, 24 hours and 48 hours postoperation2 hours, 4 hours, 6 hours, 24 hours and 48 hours postoperation

The total incidence refers to the sum of the incidence of opioid-related adverse effects at 2h, 4h, 6h, 24h and 48h postoperationOpioid-related adverse effects here including respiratory depression, hypotension, PONV and dizziness.

Secondary Outcome Measures
NameTimeMethod
Defecation timeUp to 48 hours postoperation

From the operation finished to first-time defecation

Pain severity2 hours, 4 hours, 6 hours, 24 hours and 48 hours after tracheal extubation

Using 0-10 numerical rating scale (NRS). The NRS score is ranged from 0 to 10. 0 means without pain. 1-3 means mild pain. 4-6 means moderate pain. 7-9 means severe pain. 10 means intense pain and can't bear.

Dosage of opioids2 hours, 4 hours, 6 hours, 24 hours and 48 hours after tracheal extubation

Total dosage of opioids postoperation

Incidence of intraoperative cardiovascular complicationsDuring the operation

Including the incidence of arrhythmia, the probability of using hyperensor and hypotensor.

Incidence of postoperative cardiovascular complicationsUp to 30 days postoperation

Including the incidence of arrhythmia, the probability of using hypertensor and hypotensor.

Duration of tracheal intubation removingUp to 2 hours postoperation

From anesthetic discontinuance to tracheal extubation

Duration of departing from PACUUp to 4 hours postoperation

From tracheal extubation to Aldrete score\>9. Aldrete score is the standard for departing from PACU which includes five contents to evaluate: activity, breath, blood pressure, state of consciousness and oxygen saturation by pulse oximetry (SpO2). 2 point in total for each content. 2 point refers to the best state, whereas 0 point refers to the worst state. When a patient's total score greater than 9 who will be transferred out of PACU.

Flatus timeUp to 48 hours postoperation

From the operation finished to first-time exhaust

Postoperative duration of stay in hospital30 days postoperation

The duration when patients stay in hospital after surgery.

Trial Locations

Locations (1)

Peking University People's Hospital

🇨🇳

Beijing, Beijing, China

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