Prevention and treatment of postoperative pulmonary diseases in elderly patients
Conditions
Interventions
experimental group:Ultrasound guided unilateral stellate ganglion block was performed 30min before anesthesia induction
control group:Ultrasound-guided sham block was performed 30 minutes prior to anaesthetic induction, following the exact same procedure as in the experimental group
Sponsors
People's Hospital of Jinniu District, Chengdu
Eligibility
Sex/Gender
All
Age
65 Years to 85 Years
Inclusion criteria
Inclusion criteria: 1. Age >=65 years; 2. Planned major surgery under general anesthesia (e.g., abdominal, thoracic, orthopedic); 3. ASA physical status II–IV; 4. Patients planning to undergo major surgery expected to last more than 2 hours, and in routine practice require invasive arterial pressure monitoring; 5. Agree to participate
Exclusion criteria
Exclusion criteria: 1. Preexisting pulmonary diseases such as lung infection, pulmonary embolism, acute respiratory failure, or a history of upper respiratory tract infection within 1 week before surgery, with abnormal baseline pulmonary status affecting complication assessment. 2. Contraindications to stellate ganglion block (local cervical infection, coagulation disorders, cervical spine deformity or tumor, allergy to local anesthetics, history of bilateral stellate ganglion block). 3. Severe concurrent cardiovascular and cerebrovascular diseases (severe chronic obstructive pulmonary disease (COPD) (GOLD III or IV or requiring (non-invasive) ventilation and/or home oxygen therapy), acute myocardial infarction, serious arrhythmia, acute cerebral infarction, heart failure NYHA Class III-IV), severe liver or kidney dysfunction (such as liver failure, chronic renal failure, glomerular filtration rate <30 mL/min/1.73 m^2), advanced malignant tumors or expected survival <3 months, which may interfere with outcome evaluation. 4. Long-term preoperative use of glucocorticoids, immunosuppressants, or presence of autoimmune diseases, severe malnutrition (albumin <30 g/L), affecting the body’s inflammatory response and repair ability. 5. Inability to cooperate with pulmonary function tests or postoperative follow-up, or anticipated need for long-term mechanical ventilation or transfer to another hospital after surgery, leading to missing complication and rehabilitation data. 6. Body mass index (BMI) exceeding 35 kg/m^2. 7. Chest imaging indicating pneumothorax or giant pulmonary bullae. 8. Anticipated need for mechanical circulatory support or reoperation after surgery. 9. Patients participating in other clinical trials. 10. History of pulmonary function failure, requiring home oxygen or ventilator support.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pulmonary complications within 7 days after surgery; | — |
Secondary
| Measure | Time frame |
|---|---|
| Severity of pulmonary complications;Oxygenation index;Inflammatory markers;Total length of stay and number of unplanned ICU admissions;Postoperative pain score (NRS);Total oral morphine equivalent (OME) consumption in the first 48 hours after surgery;30 day postoperative mortality; | — |
Countries
China
Contacts
Public ContactLiu Yan
People's Hospital of Jinniu District, Chengdu
Outcome results
None listed