Effect of TPVB on Postoperative Pain and Cognitive Function After VATS in Elderly Patients
NCT ID: NCT05364216
Last Updated: 2023-08-01
Study Results
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Basic Information
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COMPLETED
NA
92 participants
INTERVENTIONAL
2022-05-12
2023-05-31
Brief Summary
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Detailed Description
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Group C received general anesthesia, and group T received 0.375% ropivacaine 20 ml of thoracic paravertebral nerve block combined with general anesthesia after induction of anesthesia. SBP（Systolic Blood Pressure）/DBP （Diastolic Pressure）and HR（Heart Rate） of the two groups were recorded before anesthesia induction (T1), at the time of intubation (T2), at the beginning of surgery (T5), immediately after surgery (T6), and five minutes after extubation (T7) . rScO2（Regional cerebral oxygen saturation） was recorded in both groups at (T1), five minutes after induction(T3), five minutes after single lung ventilation on lateral recumbent(T4), (T6), (T7). The incidence of acute and chronic pain after surgery was compared between the two groups by NRS（Numerical Rating Scale）after extubation , one day after surgery, and three months after surgery.
The cognitive function of the two groups was assessed with the Mini Mental State Scale (MMSE) and the Montreal Cognitive Assessment Scale (MoCA-Beijing) on the day before , one day after and three months after surgery, comparing the incidence of PND (postoperative cognitive dysfunction) between the two groups.Analyze whether paravertebral block can reduce the incidence of POD by improving brain oxygen saturation.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
DOUBLE
Study Groups
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Group C
The general anesthesia was used.In this group, cognitive function was evaluated by MMSE and MoCA scale on one day before surgery, one day after surgery, and three months after surgery. Acute postoperative pain was was evaluated by VAS after extubation , one day after surgery, Chronic postsurgical pain was evaluated by VAS on three months after surgery.
Measurement of cognitive function
Patients undergoing thoracoscopic surgery underwent general anesthesia.MMSE and MoCA were assessed at one day before surgery, one day after surgery, and three months after surgery
Group T
Group T received 0.375% ropivacaine 20ml thoracic paravertebral nerve block combined with general anesthesia under ultrasound guidance after anesthesia induction.
Measurement of cognitive function
Patients undergoing thoracoscopic surgery underwent general anesthesia.MMSE and MoCA were assessed at one day before surgery, one day after surgery, and three months after surgery
Thoracic paravertebral block
The patient was placed in lateral supine position, and the T5 spinous process was moved 2 to 3 cm laterally to the operative side as the puncture point, and the pleura and T5 transverse process were observed, and the paraspinal space was observed on the lower lateral side of the transverse process. Using in-plane technique, the needle position was adjusted under ultrasound visualization to reach the paraspinal space. 20ml 0.375% ropivacaine was injected into the suction syringe when there was no blood or gas, and the drug liquid could be seen spreading outside the pleura. "Landscape sign" appeared, indicating successful block
Non-surgical controls
Age and sex-matched community people are included for three sessions of MMSE test evaluation for calculation of POD incidence as normal control to in Z value calculation of POD incidence to rule out learning effect.
The assessment of cognitive function
Participants were assessed for MMSE and MoCA at the same period as the group C
Interventions
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Measurement of cognitive function
Patients undergoing thoracoscopic surgery underwent general anesthesia.MMSE and MoCA were assessed at one day before surgery, one day after surgery, and three months after surgery
Thoracic paravertebral block
The patient was placed in lateral supine position, and the T5 spinous process was moved 2 to 3 cm laterally to the operative side as the puncture point, and the pleura and T5 transverse process were observed, and the paraspinal space was observed on the lower lateral side of the transverse process. Using in-plane technique, the needle position was adjusted under ultrasound visualization to reach the paraspinal space. 20ml 0.375% ropivacaine was injected into the suction syringe when there was no blood or gas, and the drug liquid could be seen spreading outside the pleura. "Landscape sign" appeared, indicating successful block
The assessment of cognitive function
Participants were assessed for MMSE and MoCA at the same period as the group C
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* American Society of Anesthesiologists (ASA) grades I-III
* The score of Mini Mental state examination≥24
* The score of Montreal Cognitive Assessment-Beijing Scale≥26
Exclusion Criteria
* The score of Mini Mental state examination≤23
* The score of Montreal Cognitive Assessment-Beijing Scale≤25
* Preoperative psychiatric disorders or long-term use of drugs affecting the psychiatric system
* Have severe visual, hearing, speech impairment or other inability to communicate with the visitor
* Have contraindications to thoracic parathymic block
* Refuse to sign informed consent
60 Years
90 Years
ALL
Yes
Sponsors
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The First Hospital of Qinhuangdao
OTHER_GOV
Responsible Party
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Principal Investigators
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Qinshuang Liu, master
Role: STUDY_DIRECTOR
The First hosptial of Qinhuangdao
Linyu Shi, master
Role: STUDY_CHAIR
The First hosptial of Qinhuangdao
Locations
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The First hosptial of Qinhuangdao
Qinhuangdao, Hebei, China
Countries
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Other Identifiers
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20220503
Identifier Type: -
Identifier Source: org_study_id
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