Liver tumor
Conditions
Interventions
Test group:Bilateral thoracic paravertebral block combined with fluid-restricted controlled low central venous pressure general anesthesia
Control group:General anesthesia using vasoactive drugs and fluid restriction to maintain controlled low central venous pressure
Sponsors
Fuzhou University Affiliated Provincial Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Inclusion criteria
Inclusion criteria: 1. Male or female individuals aged between 18 and 70 years old. 2. Body Mass Index (BMI) within the range of [18.0 - 30.0] kg/m² (including the critical value). 3. Diagnosed clinically or pathologically as hepatocellular carcinoma and planned to undergo laparoscopic liver resection. 4. American Society of Anesthesiologists (ASA) classification is I-II. 5. Single tumor located in the right liver (V, VI, VII or VIII segment), with a tumor diameter of 4-8 cm. 6. The expected resection range involves at least one liver segment. 7. No cancerous portal vein or hepatic vein thrombosis. 8. Indocyanine Green 15-minute retention rate (ICGR15) = 80 points. 11. Liver function Child-Pugh classification is A grade. 12. Acceptable coagulation function: INR = 70 × 10?/L, prothrombin activity >= 60%. 13. Voluntary participation in this study and signing a written informed consent.
Exclusion criteria
Exclusion criteria: 1. There is extrahepatic metastasis. 2. There is a history of open surgery in the upper abdomen. 3. Those who plan to undergo other surgeries at the same time. 4. There is coagulation dysfunction (excluding the criteria in item 11), with an international normalized ratio > 1.5 - 2.0, and cannot be effectively corrected through vitamin K or fresh frozen plasma. Platelet count = 450 ms, for females >= 470 ms (if the first abnormality is detected, it can be measured three times and averaged). 7. Pulmonary diseases: pneumoconiosis, acute respiratory tract infection, bronchiectasis, pulmonary hypertension, uncontrolled severe asthma, severe chronic obstructive pulmonary disease or interstitial lung disease, accompanied by respiratory failure at rest (PaO2 50 mmHg). 8. Renal insufficiency (serum creatinine > 2 mg/dL or requiring dialysis). 9. Severe electrolyte disorders (such as hypokalemia, hyponatremia) and acidosis. 10. Uncontrolled hypertension (continuous 2 or more measurements of resting sitting systolic blood pressure >= 160 mmHg, or diastolic blood pressure >= 100 mmHg). 11. History of local anesthetic allergy. 12. Spinal surgery history, spinal curvature, skin infection at the puncture site. 13. Patients who cannot cooperate with paravertebral block. 14. Patients with poor compliance, impaired mental state or language communication disorders. 15. Patients and their families refuse to accept necessary intraoperative monitoring and invasive procedures (such as arterial puncture, central venous puncture, etc.). 16. (Note: Hepatectomy combined with cholecystectomy is not an exclusion criterion.)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The proportion of patients with a liver surgery wound bleeding score of =<=2 points; | — |
Secondary
| Measure | Time frame |
|---|---|
| Time of liver parenchyma resection (minutes);Portal vein occlusion/opening cycle (minutes): Duration of each Pringle method occlusion;Total blood loss during the operation (ml);Whether blood transfusion is required and the volume of blood transfusion (in milliliters);Usage of vasoactive drugs (types, doses);Riker's Sedation-Agitation Scale;Improved Aldrete Score;Blood lactate and hemoglobin values;Pain score; | — |
Countries
China
Contacts
Public ContactDanfeng Wang
Fuzhou University Affiliated Provincial Hospital
Outcome results
None listed