VATS Block for Uniportal Video-assisted Thoracoscopic Surgery

NCT ID: NCT03083080

Last Updated: 2017-03-22

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-03-27
• Study Completion Date: 2019-03-26

Brief Summary

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.

Conditions

Efficacy and Safety of VATS Block

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

VATS block (ropivacaine + epinephrine)

VATS block is the peripheral nerve block for video-assisted thoracic surgery, whose injection is administered at the site of chest wall incision.

Group Type: EXPERIMENTAL

VATS

Intervention Type: PROCEDURE

VATS is the abbreviation of video-assisted thoracic surgery, which aims to minimize the wound for thoracic surgery and to enhance patient recovery after surgery

Ropivacaine

Intervention Type: DRUG

30 mL 0.5% ropivacaine is used to achieve VATS block

Epinephrine

Intervention Type: DRUG

1:400000 epinephrine is mixed with ropivacaine (local anesthetic) to reduce the risk of local anesthetic systemic toxicity

Interventions

VATS

VATS is the abbreviation of video-assisted thoracic surgery, which aims to minimize the wound for thoracic surgery and to enhance patient recovery after surgery

Intervention Type: PROCEDURE

Ropivacaine

30 mL 0.5% ropivacaine is used to achieve VATS block

Intervention Type: DRUG

Epinephrine

1:400000 epinephrine is mixed with ropivacaine (local anesthetic) to reduce the risk of local anesthetic systemic toxicity

Intervention Type: DRUG

Eligibility Criteria

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

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 79 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Taipei Medical University WanFang Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Central Contacts

Jui-An Lin

Role: CONTACT

juian.lin@tmu.edu.tw

+886-2-29307930 ext. 2160

Other Identifiers

201504056

Identifier Type: -

Identifier Source: org_study_id