Esophageal Neoplasms
Conditions
Keywords
Circulatory and Respiratory Physiological Phenomena, Thoracoscopy
Brief summary
Video-assisted thoracoscopic surgery (VATS) has become a standard technique for addressing all types of thoracic pathology. Insufflation of carbon dioxide (CO2) into the operated chest cavity could increase lung collapse and improve surgical field view. The actual thoracic pressure values may not be identical with the presetting on the insufflator display. This overshoot pressure during VATS may compromise cardiac and pulmonary function. The purpose of this study is to evaluate the effects of intrathoracic pressure overshoot during two-lung ventilation on the hemodynamic and respiratory function and clarify the relative safety of two different techniques of insufflation.
Interventions
DEVICEInsufflation of carbon dioxide (CO2)
After patients were positioned, CO2 was insufflated into right pleural cavity at eight or twenty L/min. during video-assisted thoracoscopic surgery, thoracic pressure, hemodynamic and respiratory parameters were recorded.
Sponsors
Daping Hospital and the Research Institute of Surgery of the Third Military Medical University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists (ASA) Physical Status Ⅰ,Ⅱ * Patients with esophageal carcinoma * Elective video-assisted thoracic surgery
Exclusion criteria
* Allergic to drugs used in the study * Refusal of VAST * Arrhythmia or treated with antiarrhythmic drug * Surgery type were converted to thoracotomy, * Massive intraoperative blood loss (\> 400ml)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| thoracic pressure overshoot | one hour during CO2 insufflation | Time and value of thoracic pressure overshoot during CO2 insufflation |
| Hemodynamic change | one hour during CO2 insufflation | Hemodynamic changes during each overshoot including Systolic Blood Pressure, Central Venous Pressure and Heart Rate |
| Respiratory change | one hour during CO2 insufflation | Respiratory changes during each overshoot including Peak Inspiratory Pressure, Pressure flat, Arterial Oxygen Saturation and End-tidal Carbon dioxide |
Outcome results
None listed