Video-assisted Thoracoscopic Surgery (VATS), Lung Cancer (Diagnosis), Pulmonary Infections, Respiratory Failure Without Hypercapnia, Pleural Effusion Due to Another Disorder (Disorder), Atelectasis, Bronchospasm, Pneumothorax, Pulmonary Embolism (Diagnosis), Bronchopleural Fistula, Acute Respiratory Distress Syndrome (ARDS)
Conditions
Keywords
Paravertebral Block (PVB), Video-Assisted Thoracoscopic Surgery (VATS), Postoperative Complications
Brief summary
This study aims to evaluate the clinical association between intraoperative paravertebral block and the reduction of postoperative complications following thoracic surgery.
Detailed description
This study is designed as an observational investigation combining both retrospective and prospective components, focusing on patients undergoing thoracic surgery, primarily pulmonary and mediastinal procedures. Retrospective analysis: We will collect data from patients across multiple campuses of Tongji Hospital who previously underwent thoracic surgery with intraoperative paravertebral block. These cases will be retrospectively analyzed to explore the association between paravertebral block and the reduction of postoperative complications. Prospective evaluation: For patients enrolled prospectively, we will collect perioperative biochemical parameters, including MMP3, neutrophils, leukocytes, PCT, CRP, and other relevant regulatory factors. Postoperative outcomes will be assessed by recording cough and pain scores, as well as time to first flatus and defecation at 24 and 48 hours after surgery. In addition, patients will be followed for 30 days to document the incidence of postoperative complications. Clinical correlation: The association between the measured biomarkers and patient outcomes will be systematically evaluated to determine their clinical relevance in predicting prognosis.
Interventions
PROCEDUREParavertebral Block (PVB)
Participants in this arm will receive a paravertebral nerve block (PVB) performed intraoperatively under ultrasound guidance prior to the thoracic surgical procedure. The block will target the relevant thoracic vertebral levels corresponding to the surgical site. Standard local anesthetic agents will be administered according to institutional protocols. This intervention aims to provide perioperative analgesia, reduce postoperative pain, and potentially decrease the incidence of postoperative complications. All participants will also receive standard intraoperative monitoring and anesthesia management as per routine clinical practice.
Sponsors
Tongji Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Intervention model description
This study is designed as an observational investigation combining both retrospective and prospective components, focusing on patients undergoing thoracic surgery, primarily pulmonary and mediastinal procedures.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Male or female participants aged 18 years or older. 2. Scheduled to undergo thoracic surgery via Video-Assisted Thoracoscopic Surgery (VATS) or Robotic-Assisted Thoracoscopic Surgery (RATS), including wedge resection, segmentectomy, lobectomy, or mediastinal surgery. 3. Signed informed consent obtained prior to study participation. -
Exclusion criteria
1. Patients who refuse to provide informed consent. 2. Anesthesiologists who have not received training in ultrasound-guided paravertebral block (PVB-US). 3. History of ipsilateral thoracic surgery. 4. Conversion to open thoracotomy during the procedure. 5. Patients who did not complete the scheduled surgery due to disease progression or medical reasons. 6. Patients who are lost to follow-up or refuse postoperative follow-up. -
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Complications | 1 to 3 months postoperatively | Postoperative complications following thoracic surgery will be assessed as the primary outcome. These complications include pulmonary infection, respiratory failure, pleural effusion, atelectasis, bronchospasm, pneumothorax, aspiration-induced lung injury, pulmonary embolism, bronchopleural fistula, and acute respiratory distress syndrome (ARDS). The incidence of these complications will be systematically recorded and analyzed to evaluate the clinical impact of the intervention. |
Countries
China
Contacts
Primary ContactGuo jiateng Guo
Outcome results
None listed