fysiologisch: invloed van sympathisch ZS op ventriculo-pulmonale koppeling lungcancer lungresection
Conditions
Interventions
None listed
Sponsors
Leids Universitair Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Patients undergoing lung resection under thoracic epidural anesthesia
Exclusion criteria
Exclusion criteria: Contra-indications for thoracic epidural: History of lung resection surgery Pregnancy or lactation Participation in a trial on investigational drugs within 3 months prior to the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| General hemodynamics and right ventricular function are determined from RV pressure-loops. Pressure*volume signals acquired during steady state yield end-diastolic and end-systolic volume (EDV, ESV), ejection fraction (EF), end-diastolic and end-systolic pressure (EDP, ESP), stroke work (SW), dP/dtMAX and dP/dtMIN, and isovolumic relaxation time constant Tau. Load-independent indices of systolic and diastolic RV function are determined from pressure* volume relations obtained during preload alteration (Trendelenburg). The end-systolic pressure*volume relation (ESPVR: ESP vs. ESV) and the preload recruitable stroke work relation (PRSWR: SW vs. EDV) quantify systolic ventricular function. In particular, the slope of the ESPVR determines end-systolic elastance Ees, which is generally considered the gold standard index for intrinsic, systolic ventricular function. The end-diastolic pressure-volume relation (EDPVR: EDP vs. EDV) is used to determine diastolic function, quantified by diastolic chamber stiffness and the stiffness constant. Right ventricular afterload is determined by effective arterial elastance Ea, calculated as ESP/SV. Ventricular-arterial coupling is quantified as Ees/Ea [28,37]. | — |
Secondary
| Measure | Time frame |
|---|---|
| Analgesia will be assessed bilaterally in the anterior axillary line by pinprick using a short beveled 25-gauge needle and by temperature discrimination using ice blocks. Analgesia is defined as the inability to detect a sharp pinprick. Results from both sides will be averaged. Assessments will be done every 5 minutes after injection of Lidocaine during 15 minutes. The following parameters will be investigated Time to initial onset of analgesia at the T3-T4 dermatomes Time until maximum cephalad spread of analgesia Time until maximum caudad spread of analgesia Highest level of analgesia Maximum numbers of segments blocked | — |
Countries
Netherlands
Outcome results
None listed