Gastrointestinal tumors in the upper abdomen (liver, gallbladder/biliary duct, stomach, pancreas, etc.)
Conditions
Interventions
Experimental group:Intraoperative thoracic epidural anesthesia
Control group:None
Sponsors
The First Affiliated Hospital of Kunming Medical University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Patients undergoing elective upper abdominal surgery (liver, gallbladder/biliary tract, pancreas, spleen, stomach) with mechanical ventilation; 2. Over 18 years old; 3.ASA Grade I-III; 4. The duration of mechanical ventilation during the operation was more than 120 minutes; 5. The patient and his family members agree and sign the anesthetic consent; 6. Stay in hospital for observation for more than 3 days after surgery; 7. The patient had no cognitive dysfunction before surgery.
Exclusion criteria
Exclusion criteria: 1. The patient or family member refuses, and the patient or family member has severe language communication barriers; 2. There is a high risk of esophageal reflux, and patients who have not strictly fasted water and a full stomach before surgery; 3. Critically ill patients with ASA grade greater than III; 4. Patients with COPD before operation, and Gold grade 3 or above patients; pneumothorax, large amount of pleural effusion (effusion volume> 500ml); 5. NYHA cardiac function grade 3 or above, congenital heart disease, severe arrhythmia; 6. Patients with severe liver and kidney failure; 7. Severely abnormal coagulation function, infection at the puncture site, severe scoliosis, history of spinal trauma, failure of epidural block or catheterization, history of allergy to local anesthetics; Pathological obesity, BMI>35kg/m2, combined with obesity hypoventilation syndrome; 8. Patients with peripheral neuropathy, severe anemia (Hb<30g/L), severe hypoalbuminemia (albumin<20g) or other serious blood diseases.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Driving pressure; | — |
Secondary
| Measure | Time frame |
|---|---|
| Postoperative pulmonary complications;Arterial blood gas analysis;Respiratory mechanical indicators (respiratory system compliance, peak airway pressure, mean airway pressure);Hemodynamic indicators (systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate); | — |
Countries
China
Contacts
Public ContactYu Fang
The First Affiliated Hospital of Kunming Medical University
Outcome results
None listed