Esophageal cancer is the eighth most common cancer and the sixth leading cause of cancer death worldwide. Esophageal cancer is characterized by insidious onset, rapid progression, and poor prognosis, with a marked disparity in outcomes between early and late detection. The 5-year survival rate for patients with early-stage disease can reach 90%, whereas for those with advanced-stage disease, it is
Conditions
Interventions
Intervention Group (Group H):Dexmedetomidine at a dose of 0.6 µ g/kg was administered intravenously within 15 to 20 minutes. Twenty minutes before induction, hydromorphinone at a dose of 0.6mg was slo
Control Group (Group S):Dexmedetomidine at a dose of 0.6 µ g/kg was administered intravenously within 15 to 20 minutes. Twenty minutes before induction, 10ml of normal saline was slowly injected throu
Sponsors
Zhejiang Cancer Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Age: 18 - 80 years old; 2. ASA classification: I - III grade; 3. The planned elective minimally invasive McKeown esophageal cancer radical surgery (combined thoracoscopic and laparoscopic approach) involves three-field or two-field lymph node dissection, gastric tube reconstruction, and cervical anastomosis. The surgery is divided into three stages: The first stage (thoracic stage): Thoracoscopic esophageal dissection, mediastinal lymph node dissection (including subcarinal, left and right recurrent laryngeal nerve chains, etc.); the second stage (abdominal stage): Laparoscopic gastric dissection, abdominal lymph node dissection and tube-shaped stomach construction; the third stage (cervical stage): Cervical small incision esophagogastric cervical anastomosis; 4. Voluntary participation and signing of a written informed consent form;
Exclusion criteria
Exclusion criteria: 1. Contraindications for epidural puncture (coagulation dysfunction, infection at the puncture site, severe spinal deformity, etc.); 2. Known to be allergic to the research drugs (hydromorphinone, sufentanil, ropivacaine); 3. Long-term use of opioid drugs before the operation (more than 3 months) or suffering from chronic pain syndrome; 4. Severe liver and kidney dysfunction (Child-Pugh grade C or eGFR 180 mmHg), severe arrhythmia, symptomatic heart failure (NYHA grade III-IV), or severe bradycardia (HR<50 beats per minute); 6. Previous history of ipsilateral chest surgery; 7. Communication barriers, cognitive dysfunction, or inability to cooperate with epidural operations or pain assessment; 8. Pregnant or lactating women;
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain intensity within 72 hours postoperatively (area under the curve [AUC] of the visual analog scale [VAS] at rest;Analgesia-related indicators; | — |
Secondary
| Measure | Time frame |
|---|---|
| Intraoperative stress response level;Pain intensity within 72 hours postoperatively (area under the curve of coughing VAS);Postoperative clinical outcomes;Intraoperative hemodynamic stability;Incidence and severity of postoperative delirium;Perioperative cumulative opioid consumption (in morphine milligram equivalents);Incidence of adverse reactions;Incidence and severity of chronic postoperative pain;Incidence of serious adverse events;Rehabilitation process;Quality of recovery; | — |
Countries
China
Contacts
Public ContactZhu Yejing
Zhejiang Cancer Hospital
Outcome results
None listed