Pulmonary nodule
Conditions
Interventions
Group A (Esketamine + Dexmedetomidine):Etomidate 0.2-0.3 mg/kg (slow intravenous injection) + Dexmedetomidine 0.5 µg/kg (infused over 10 minutes) + Esketamine 0.5 mg/kg
Continuous infusion of dexmedetomidine at a rate of 0.2–0.5 µg/(kg/h) combined with esketamine at a rate of 0.25 mg/(kg/h)
Group B (Sufentanil + Dexmedetomidine ):Etomidate 0.2–0.3 mg/kg (slow intravenous injection) plus dexmedetomidine 0.5 µg/kg and sufentanil 0.3 µg/kg
insertion of laryngeal mask airway with spontaneous breathing preserved. Continuous infusion of dexmedetomidine at a rate of 0.2–0.5 µg/(kg/h) to maintain the BIS value within the range of 40–60.
Sponsors
Anhui Provincial Cancer Hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: (1) Definite diagnosis: Peripheral pulmonary nodules confirmed by imaging examinations, with a diameter <= 3 cm, requiring wedge resection, segmentectomy, or lobectomy of the lung. (2) Good physical condition: American Society of Anesthesiologists (ASA) physical status classification ?-?, indicating the patient is in good health and can tolerate surgery and anesthesia. (3) Suitable intubation conditions: According to Mallampati test assessment, the subjects have intubation conditions of grade ?-?, indicating their airway anatomical structure is suitable for airway management procedures, reducing potential difficulties and risks during intubation. (4) No severe comorbidities: Subjects have no history of severe cardiovascular diseases, chronic obstructive pulmonary disease (COPD), pulmonary tuberculosis, active mental illnesses, hematological diseases, etc., to minimize the potential impact of these diseases on the study results. (5) Moderate body mass index (BMI): BMI < 25, avoiding surgical and anesthetic risks potentially caused by obesity while ensuring a certain degree of homogeneity in body weight among the study subjects.
Exclusion criteria
Exclusion criteria: (1) Type and size of pulmonary space-occupying lesions: Patients with central pulmonary space-occupying lesions or those with a diameter > 3 cm are excluded, as the complexity of their condition and surgical difficulty may be inconsistent with the study's target population. (2) Surgical scope: Patients requiring pneumonectomy are not included in the study. Pneumonectomy differs significantly from wedge resection, segmentectomy, and lobectomy in terms of surgical trauma and postoperative recovery, which may affect the interpretation of study results. (3) Poor physical condition: Patients with ASA physical status classification >= ? are excluded. Such patients usually have severe comorbidities, leading to higher surgical and anesthetic risks, which do not meet the study's requirements for the physical condition of subjects. (4) Abnormal airway anatomy: Patients with congenital or acquired oropharyngeal malformations or a history of laryngeal surgery are excluded. These conditions may increase the difficulty and risk of airway management, hindering the smooth progress of the study. (5) Mental status: Patients with active mental illnesses are not included to ensure subjects can cooperate with the study process and reduce research interference caused by mental factors. (6) Abnormal respiratory function: Patients with preoperative hypoxemia (blood oxygen saturation = 25 are excluded to ensure a certain degree of homogeneity in body weight among subjects and reduce obesity-related surgical and anesthetic risks. (9) Failed nerve block: Patients in whom ultrasound-guided paravertebral nerve block fails are not included. As nerve block is a key component of the study, failure to perform it properly may compromise the implementation of the research protocol and the completeness of study results.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Dosage of NSAIDs administered within 24 hours after surgery;NRS scores at rest / during coughing;Serum cortisol (Cor-); | — |
Secondary
| Measure | Time frame |
|---|---|
| Serum interleukin-6 (IL-6); | — |
Countries
China
Contacts
Public ContactChaoliang Tang
Anhui Provincial Cancer Hospital
Outcome results
None listed