Diaphragm Issues, Regional Anesthesia, Thoracic Surgery, Ultrasounds
Conditions
Keywords
Ultrasounds, diaphragmatic function, thoracic surgery, regional anesthesia
Brief summary
Awake thoracic surgery is a feasible and safe alternative to general anesthesia for pulmonary biopsy in interstitial lung disease patients, but there is still no evidence as to its superiority in terms of outcome. However, there is extensive literature about the effect of anesthetic drugs and surgery on diaphragmatic function. Furthermore, in thoracic surgery, diaphragmatic dysfunction was associated with a higher occurrence of postoperative pulmonary complications. To assess the impact of general anesthesia on diaphragmatic function, the investigators conducted an observational prospective trial. The investigators measured both diaphragmatic excursion and Thickening Fraction at baseline and 12 hours after surgery together with pulmonary function tests and gas exchange data.
Detailed description
Awake thoracic surgery is a feasible and safe alternative to general anesthesia for pulmonary biopsy in interstitial lung disease patients, but there is still no evidence as to its superiority in terms of outcome. However, there is extensive literature about the effect of anesthetic drugs and surgery on diaphragmatic function. Furthermore, in thoracic surgery, diaphragmatic dysfunction was associated with a higher occurrence of postoperative pulmonary complications. To assess the impact of general anesthesia on diaphragmatic function, the investigators conducted an observational prospective trial. The investigators measured both diaphragmatic excursion and Thickening Fraction at baseline and 12 hours after surgery together with pulmonary function tests and gas exchange data. The investigators divided our population into two groups: one group of patients undergoing awake thoracic surgery with epidural anesthesia, and the other group undergoing general anesthesia. Forty-one patients were recruited and the Thickening Fraction percentage, calculated as (End Inspiratory thickness-End Expiratory thickness)/End Expiratory thickness, was evaluated by means of an ultrasound-assisted method, using a high frequency (10 MHz) linear probe.
Interventions
PROCEDURERegional awake anesthesia
We want to assess the impact of regional anesthesia on diaphragmatic function in patients undergoing Video-assisted thoracoscopic surgery pulmonary biopsy in interstitial lung disease
Sponsors
University of Turin, Italy
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients scheduled for lung biopsy from February 2019 to September 2020
Exclusion criteria
* pregnancy, * Body Mass Index \>35, * Inability to provide informed consent, * American Society of Anesthesiologists physical status classification score of IV * Recommended postoperative ICU care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diaphragmatic maximal function | 12 hours | Measured with diaphragmatic excursion |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain scores | 24 hours | Numeric rate scale |
| Postoperative Nausea and Vomiting | 24 hours | Presence/absence of Postoperative Nausea and Vomiting |
Countries
Italy
Outcome results
None listed