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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
144
Intraoperative dexmedetomidine infusion
Tri-Service General Hospital
Taipei, Taiwan
RECRUITINGCough
The incidence of cough reflex during surgery and severity Cough severity: 1=none, 2=slight, 3=moderate, 4=severe
Time frame: Intraoperative period
Intraoperative fentanyl consumption
Fentanyl bolus for cough reflex and limb movement
Time frame: Intraoperative period
Total fentanyl consumption
Total fentanyl requirement during surgery
Time frame: Intraoperative period
Total propofol consumption
Total propofol requirement during surgery
Time frame: Intraoperative period
Intraoperative adverse events
The incidence of hypotension, bradycardia and hypoxia
Time frame: Intraoperative period
Postoperative numeric rating scale
Numeric rating scale within postoperative 48 hours NRS scores is labeled from zero to ten, with zero being an example of someone with no pain and ten being the worst pain possible.
Time frame: Postoperative 48 hours
Postoperative opioid requirement
Postoperative opioid requirement within postoperative 48 hours
Time frame: Postoperative 48 hours
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