VATS Block for Uniportal Video-assisted Thoracoscopic Surgery

Taipei Medical University

Status

Unknown

Conditions

Efficacy and Safety of VATS Block

Treatments

Drug: Epinephrine

Drug: Ropivacaine

Procedure: VATS

Study type

Interventional

Funder types

Other

Identifiers

NCT03083080

201504056

Details and patient eligibility

About

Traditionally, video-assisted thoracic surgery is performed under general anesthesia with double-lumen endotracheal tube. However, the complications associated with this large tube as well as inhalation anesthetics are frequently reported. Therefore, currently there is a trend toward non-intubated anesthesia methods for video-assisted thoracic surgery, which includes thoracic epidural block, peripheral nerve block, local anesthesia, local combined with peripheral nerve block, etc. Thoracic epidural block demands a high technique, but still risks catastrophic neurological complications in case of accidental dural puncture. Local anesthesia, perhaps more straightforward, however may need supplemental analgesia during incision, which will inevitably interrupt surgery and negatively affect the patients. This study aims to apply ultrasound guidance during local anesthetic injection for local anesthesia-based video assisted thoracic surgery, which helps inject the local anesthetic into the key intercostal nerve plane to provide more specific and precise blockade, thus avoiding the chance of blind injection. At the same time, ultrasound guidance has the potential to reduce the risk of systemic toxicity, prolong the duration of analgesia postoperatively, and facilitates postoperative recovery.

Enrollment

30 estimated patients

Sex

All

Ages

20 to 79 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Adults younger than 80 years old and weighing between 50-90 kg are scheduled for one-port video assisted thoracic surgery .

Exclusion criteria

Anticipated difficult airway
Obvious coagulation abnormality
Psychiatric patients or drug addiction
Emergency operation or patients with a full stomach
Difficulty in language expression
Allergic to local anesthetic, morphine, or NSAID
BMI > 35
Pregnancy
Respiratory insufficiency
Severe pleural adhesion
Need for pleurodesis
Refuse patient-controlled analgesia
Patients with a pacemaker
Severe liver dysfunction (serum albumin<25g/l or Child-Pugh score≧10)
Severe kidney dysfunction (creatinine clearance<30ml/min)
Inflammatory bowel disease
Congestive heart failure (NYHA II-IV)
Confirmed ischemic heart disease, peripheral arterial disease and/or cerebral vascular disease
Patients with a high intra-ocular pressure (e.g. glaucoma)
Neurological symptoms over the ipsilateral upper part of the body