Analgesia, Dexmedetomidine, Thoracoscopy
Conditions
Keywords
Dexmedetomidine, Thoracoscopy, Analgesia
Brief summary
This prospective study aims to evaluate the effectiveness of intraoperative DEX for postoperative analgesia and recovery after non-intubated VATS. In addition, the investigators observe the impact of DEX on anesthetic requirements, hemodynamic parameters, and adverse events during non-intubated VATS.
Detailed description
The non-intubated thoracoscopic approach has been adapted for use with major lung resections. The non-intubated VATS tries to minimize the adverse effects of tracheal intubation and general anesthesia, such as intubation-related airway trauma, ventilation-induced lung injury, residual neuromuscular blockade, and postoperative nausea and vomiting. An adequate analgesia allows VATS to be performed in sedated patients and the potential adverse effects related to general anesthesia and selective ventilation can be avoided. Dexmedetomidine (DEX), a highly selective alpha-2 receptor agonist, is increasingly used in anesthesia with sedative, hypnotic, anxiolytic, sympatholytic, and analgesic effects. It can also attenuate perioperative stress and inflammation and preserve the immunity of surgical patients, which may contribute to reduced postoperative complications and improved clinical outcomes. This study aims to evaluate the effectiveness of intraoperative DEX for postoperative analgesia and recovery after non-intubated VATS. In addition, the investigators observe the impact of DEX on anesthetic requirements, hemodynamic parameters, and adverse events during non-intubated VATS.
Interventions
DRUGDexmedetomidine infusion
Intraoperative dexmedetomidine infusion
Sponsors
Tri-Service General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists (ASA) score of I-III patients receiving video-assisted thoracoscopic surgery
Exclusion criteria
* Age \< 18 or \> 80 years * ASA classifications \> III * Pregnancy * Known allergies to any drugs used in the study * Emergency surgery * Patient refusal * Chronic pain history
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cough | Intraoperative period | The incidence of cough reflex during surgery and severity Cough severity: 1=none, 2=slight, 3=moderate, 4=severe |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative fentanyl consumption | Intraoperative period | Fentanyl bolus for cough reflex and limb movement |
| Total fentanyl consumption | Intraoperative period | Total fentanyl requirement during surgery |
| Total propofol consumption | Intraoperative period | Total propofol requirement during surgery |
| Intraoperative adverse events | Intraoperative period | The incidence of hypotension, bradycardia and hypoxia |
| Postoperative numeric rating scale | Postoperative 48 hours | Numeric rating scale within postoperative 48 hours NRS scores is labeled from zero to ten, with zero being an example of someone with no pain and ten being the worst pain possible. |
| Postoperative opioid requirement | Postoperative 48 hours | Postoperative opioid requirement within postoperative 48 hours |
Countries
Taiwan
Outcome results
None listed