Comparison of Liposomal Bupivacaine Paravertebral Nerve Block Versus Intercostal Nerve Block on Postoperative Glycemic Variability in Patients Undergoing Minimally Invasive Pulmonary Resection: A Randomized Controlled Non-Inferiority Trial
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Yingqi Weng, MD
- Telefonnummer: +86-15074834690
- E-mail: 651922615@qq.com
Undersøgelse Kontakt Backup
- Navn: Hongying Zhu
- Telefonnummer: +86-15970330540
- E-mail: 2506627021@qq.com
Studiesteder
-
-
Hunan
-
Changsha, Hunan, Kina, 410000
- Department of Anesthesiology, Xiangya Hospital, Central South University
-
Kontakt:
- Yingqi Weng, MD
- Telefonnummer: +86-15074834690
- E-mail: 651922615@qq.com
-
Kontakt:
- Hongying Zhu
- Telefonnummer: +86-15970330540
- E-mail: 2506627021@qq.com
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Aged 18-70 years, with American Society of Anesthesiologists (ASA) physical status I-III, scheduled for uniportal or multiportal video-assisted thoracoscopic (VATS) minimally invasive pulmonary resection under general anesthesia.
- Planned to receive liposomal bupivacaine regional block analgesia under direct thoracoscopic visualization.
- Body mass index (BMI) 18-30 kg/m².
- Willing and able to cooperate with the study procedures and provide written informed consent.
Exclusion Criteria:
- Regularly taking beta-blockers (for ≥2 weeks) or long-term use of high-dose glucocorticoids (prednisone ≥20 mg/day for >2 weeks).
- Known history of diabetes mellitus, or regular use of glucose-lowering agents (oral agents or insulin) before surgery.
- Planned postoperative admission to the intensive care unit (ICU).
- Concurrent severe cardiac (New York Heart Association class III or higher), hepatic (e.g., cirrhosis), or renal insufficiency (glomerular filtration rate <30 mL/min/1.73 m²), or neuropsychiatric disorders.
- Contraindications to regional block or to any study medication, including but not limited to infection or tumor invasion at the puncture site, coagulation disorders, or allergy to any drug used in the study.
- Alcohol dependence: meeting the DSM-5 criteria for severe alcohol use disorder (AUD), or clinically judged as alcohol dependence (regardless of liver function status).
- Pregnancy or lactation (for men and women of childbearing potential, effective contraception is required until 3 months after surgery, and donation of sperm or eggs is prohibited).
- Participation in another interventional drug trial.
- Regular use of analgesics for acute or chronic pain within 2 weeks before surgery.
- Concurrent severe infection.
- Prior ipsilateral intrathoracic surgery or severe pleural adhesions (estimated to preclude successful thoracoscopic visualization and completion of the block).
- Psychiatric or cognitive disorders that would impair the ability to cooperate with postoperative follow-up.
- Any other condition that, in the investigator's judgment, would make the patient unsuitable for participation in the trial (for medical or safety reasons).
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Aktiv komparator: kontrolgruppe
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Following induction of general anesthesia, the surgeon will perform thoracoscopic intercostal nerve blocks using liposomal bupivacaine (prepared as 20 mL of 6.65 mg/mL solution diluted with 20 mL normal saline to 40 mL total) to cover the surgical incision and pleural irritation areas, typically at the 3rd-8th intercostal spaces.
Under direct vision, 4.0 mL of the diluted solution will be injected at each space at a site 3-5 cm lateral to the spine, for a total liposomal bupivacaine dose of 159.6 mg (24 mL).
Injections will be slow and fractionated, with aspiration for blood or CSF before each injection, and care will be taken to prevent overdose and systemic toxicity.
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Eksperimentel: behandlingsgruppe
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Following induction of general anesthesia, a T3-T8 paravertebral nerve block will be performed by the surgeon under thoracoscopic guidance.
Liposomal bupivacaine (6.65 mg/mL) will be diluted with normal saline (20 mL + 20 mL = 40 mL total).
Under direct vision, 4.0 mL of the diluted solution will be injected evenly at each level, lateral to the sympathetic chain, for a total liposomal bupivacaine dose of 159.6 mg (24 mL).
Injections will be slow and fractionated, with aspiration for blood or cerebrospinal fluid prior to each injection, and care will be taken to prevent overdose and systemic toxicity.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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Coefficient of Variation of Blood Glucose
Tidsramme: 48 hours post-surgery
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48 hours post-surgery
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Glycated Serum Protein (GSP)
Tidsramme: Preoperatively and on the first postoperative day
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Preoperatively and on the first postoperative day
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|
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Heart Rate Variability
Tidsramme: Preoperatively and on the first postoperative day, the second postoperative day, and the third postoperative day
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Preoperatively and on the first postoperative day, the second postoperative day, and the third postoperative day
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Fasting Serum Insulin
Tidsramme: Preoperatively and on the first postoperative day
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Preoperatively and on the first postoperative day
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Numerical Rating Scale (NRS) Pain Score
Tidsramme: Preoperatively and on the first postoperative day, the second postoperative day, and the third postoperative day
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Numerical Rating Scale (NRS) Pain Score Scale range: 0 (no pain) to 10 (worst imaginable pain).
Higher scores indicate more severe pain.
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Preoperatively and on the first postoperative day, the second postoperative day, and the third postoperative day
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Fasting C peptide
Tidsramme: Preoperatively and on the first postoperative day
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Serum fasting C-peptide concentration measured by chemiluminescent immunoassay
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Preoperatively and on the first postoperative day
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Cortisol
Tidsramme: Preoperatively and on the first postoperative day
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Serum cortisol concentration measured by chemiluminescent immunoassay
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Preoperatively and on the first postoperative day
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Yingqi Weng, MD, Department of Anesthesiology, Xiangya Hospital, Central South University
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- Ethics Approval No. 202606086
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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