Dexmedetomidine in Non-intubated VATS

Tri-Service General Hospital

Status and phase: Enrolling; Phase 4

Conditions: Thoracoscopy; Dexmedetomidine; Analgesia

Treatments: Drug: Dexmedetomidine infusion

Study type: Interventional

Funder types: Other

Identifiers

NCT05863416

B202305049_V2

Details and patient eligibility

About

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.

Full 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.

Enrollment: 144 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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144 participants in 2 patient groups

Group Saline

Active Comparator group

Description:

Propofol-based total intravenous anesthesia with saline infusion

Treatment:

Drug: Dexmedetomidine infusion

Group Dexmedetomidine

Experimental group

Description:

Propofol-based total intravenous anesthesia with dexmedetomidine infusion

Treatment:

Drug: Dexmedetomidine infusion