Heart valve disease
Conditions
Interventions
RP-D group:1 µg/kg dexmedetomidine combined with 30 mL 0.75% ropivacaine, diluted with 0.9% saline to a total volume of 60 mL for pectoral fascia plane block
LB-H group:20 mL of 266 mg LB diluted with 0.9% saline to a total volume of 60 mL for pectoral fascia plane block
LB-L group:Dilute 266 mg of LB in 20 mL with 0.9% saline evenly to a total volume of 80 mL, and use 60 mL of it for pectoral fascia plane block.
Sponsors
Zhejiang Provincial People's Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. NYHA cardiac function classification: Class III or below; 2. Age >=18 years; 3. Elective right axillary minimally invasive cardiac surgery under CPB [including valve repair or replacement, ascending aorta replacement, left ventricular outflow tract unblocking for hypertrophic obstructive cardiomyopathy, i.e., Minimally-invasive Electro Septal Myectomy (MESM), etc.]; 4. Anesthesia ASA classification: Class 1-3; 5. The patient or their legal guardian has signed informed consent.
Exclusion criteria
Exclusion criteria: 1. Patients undergoing deep hypothermic extracorporeal circulation; 2. Secondary cardiac surgery; 3. Heart function Class III or above; 4. Pulmonary hypertension (mean pulmonary artery pressure >= 25 mmHg); 5. Allergy to local anesthetics; 6. Emergency surgery; 7. Severe liver dysfunction (alanine aminotransferase > 3 times the upper limit of normal or aspartate aminotransferase > 3 times the upper limit of normal), renal dysfunction (creatinine > 1.5 times the upper limit of normal); 8. Pregnant or breastfeeding women; 9. Severe neurological or psychiatric disorders.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Average pain score within 72 hours post-surgery;Cumulative consumption of opioids for postoperative rescue analgesia (morphine milligram equivalents);Frequency and dosage of non-opioid analgesic use (such as acetaminophen, nonsteroidal anti-inflammatory drugs, tramadol, etc.); | — |
Secondary
| Measure | Time frame |
|---|---|
| Measure LB blood drug concentration at 1h, 4h, 12h, 24h, 48h, and 72h postoperatively.;Intraoperative analgesic effect, i.e., the doses of sufentanil and remifentanil used during surgery;Pain score immediately after extubation;Time of Endotracheal Tube Removal After Surgery;Duration of postoperative analgesia;Duration of stay in the intensive care unit;Postoperative hospital stay;Assess respiratory function indicators at 1h, 6h, 12h, and 24h postoperatively;Postoperative high-flow oxygen therapy situation;Postoperative pulmonary complications within 7 days (atelectasis, pulmonary edema, pneumonia, respiratory failure, etc.);Postoperative nausea and vomiting;Occurrence of postoperative complications such as urinary retention, itching, and dizziness;Recovery Quality Questionnaire Assessment: Recovery Quality 30 Days After Surgery; | — |
Countries
China
Contacts
Public ContactMeiJuan Yan
Zhejiang Provincial People's Hospital
Outcome results
None listed