Infusão Contínua de Lidocaína Através de Tubo de Drenagem Torácica Fechado para Controle da Dor Após Ressecção Pulmonar Parcial Toracoscópica
Efeitos da infusão contínua de lidocaína via tubo fechado de drenagem torácica na analgesia pós-operatória para pacientes submetidos à ressecção pulmonar parcial toracoscópica: um ensaio clínico controlado randomizado de centro único
The goal of this clinical trial is to learn about the effects on postoperative analgesia of continuous lidocaine infusion via closed chest drainage tube for patients undergoing thoracoscopic partial lung resection. The main questions it aims to answer are:
- To explore whether continuous lidocaine pumping via closed chest drainage tube has good analgesic and anti-inflammatory effects for patients undergoing partial thoracoscopic pneumonectomy.
- Whether the multimodal analgesia combined with continuous lidocaine pump can reduce the postoperative application of opioids, reduce the occurrence of postoperative complications, and promote the recovery of postoperative lung function and accelerate recovery.
For participants who undergoing the thoracoscopic partial lung resection with postoperative indwelling drainage tube, the epidural tube fixed in the drainage tube is connected to the completed infusion pump (marking the chest drain for analgesia). The comparison group only accept the intravenous analgesia after surgery.
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
At present, multimodal analgesia has been the most commonly used approaches for the treatment of postoperative pain of thoracic surgery, including steroidal anti-inflammatory drugs, administration of opioid, and local anesthesia.
The investigators found that continuous lidocaine analgesia with local anesthesia through thoracic closed drainage tube could improve postoperative pain caused by drainage tube retention, reduce postoperative pain score, and improve postoperative recovery of respiratory function in patients. In the protocol, lidocaine was continuously pumped with a superficial anesthetic effect on the pleura, while mucosal absorption was almost equivalent to intravenous infusion, so its systemic anti-inflammatory effect is also explored.
In the protocol，participants will be randomized in a 1:1 ratio to the control or experimental groups. The experimental group received a continuous infusion of lidocaineThe experimental group used 2% lidocaine 100ml, and the control group was the conventional treatment group. The control group received only standard intravenous analgesia。In addition to receiving simple intravenous analgesia, the experimental group also received continuous infusion of lidocaine in the pleural cavity.
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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-
Shandong
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Jinan, Shandong, China
- Qilu Hospital
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-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- participants ages 18-70 years.
- participants undergoing thoracoscopic partial lung resection with an indwelling drainage tube after surgery.
- American Society of Anesthesiologists classification (ASA)I-III.
Exclusion Criteria:
- severe heart failure, cardiac arrhythmias,the New York Heart Association(NYHA) classification≥III.
- hypersensitivity to lidocaine,History of local anesthetic poisoning.
- severe renal or hepatic dysfunction.
- body mass index (BMI)>35 kg m-2.
- severe pleural adhesions.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: Lidocaine (intrapleural continuous infusion) + reduced-dose sufentanil PCIA
Patients receive continuous intrapleural lidocaine infusion via the closed chest drainage tube (pulse 1 mL/30 min + continuous 2 mL/h) combined with reduced-dose sufentanil patient-controlled intravenous analgesia (PCIA, 1.0-1.5 µg/kg for 48 h). |
Continuous intrapleural infusion via epidural tube fixed in the closed chest drainage tube, connected to an electronic analgesic pump (pulse 1 mL/30 min + continuous 2 mL/h). Patient-controlled intravenous analgesia (PCIA): reduced dose 1.0-1.5 µg/kg in the lidocaine arm, standard dose 2.0-2.5 µg/kg in the control arm, both for 48 h. |
|
Comparador Ativo: Standard-dose sufentanil PCIA
Patients receive standard-dose sufentanil PCIA (2.0-2.5 µg/kg for 48 h) alone. |
Patient-controlled intravenous analgesia (PCIA): reduced dose 1.0-1.5 µg/kg in the lidocaine arm, standard dose 2.0-2.5 µg/kg in the control arm, both for 48 h. |
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
postoperative pain score（NRS）
Prazo: Day 1
|
The primary outcome is the incidence of a numeric rating scale (NRS) pain score > 3 on coughing/movement at 24 hours postoperatively (movement-evoked pain only). |
Day 1
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Changes in postoperative pain
Prazo: Day 2
|
Changes in postoperative pain score (NRS) at 12h and 48h until extubation. The full name of NRS score is Numerical Rating Scale. The minimum value of NRS score is 0 and the maximum value is 10. Patients can score themselves according to the pain level corresponding to the number, A score of 0 represents painless, 1-3 represents mild pain, 4-6 represents moderate pain and should be intervened, 7-10 represents severe pain and requires urgent treatment. |
Day 2
|
|
the use of flurbiprofen axetil
Prazo: Day 3
|
the amount of rescue analgesic drugs flurbiprofen axetil used |
Day 3
|
|
the use of dolantin
Prazo: Day 3
|
the amount of rescue analgesic drugs dolantin used |
Day 3
|
|
the use of opioids
Prazo: Day 2
|
total amount of opioid use within 48h after surgery |
Day 2
|
|
postoperative adverse events
Prazo: Day 3
|
the incidence of nausea, vomiting, and vertigo after surgery |
Day 3
|
|
the amount of postoperative wound drainage
Prazo: Day 3
|
total amount of fluid drained after surgery |
Day 3
|
|
C-reactive protein
Prazo: Day 1
|
The inflammatory marker of participants will be test after surgery |
Day 1
|
|
interleukin-6
Prazo: Day 1
|
The inflammatory marker of participants will be test after surgery |
Day 1
|
|
postoperative delusion
Prazo: Day 3
|
The incidence of postoperative delusion. |
Day 3
|
|
drainage extraction
Prazo: up to 24 hours (before extubation)
|
The time taken for the patient to remove the drain after surgery |
up to 24 hours (before extubation)
|
|
ICU stay time
Prazo: From date of ICU admission until the date of leaving ICU, assessed up to 5 days.
|
The length of time the patient remains in the ICU. |
From date of ICU admission until the date of leaving ICU, assessed up to 5 days.
|
|
postoperative pulmonary complications
Prazo: Day 3
|
The probability of patients acquiring pulmonary complications after surgery. |
Day 3
|
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hospital length of stay
Prazo: From date of hospital admission until the date of discharge,assessed up to 15 days.
|
The time between hospital admission and discharge |
From date of hospital admission until the date of discharge,assessed up to 15 days.
|
|
healing rate of drainage wound
Prazo: Day 21
|
The healing rate of drainage wound at 21 days after surgery. |
Day 21
|
|
readmission rate
Prazo: Month 1
|
The readmission rate of patients in one month after surgery. |
Month 1
|
Colaboradores e Investigadores
Patrocinador
Publicações e links úteis
Publicações Gerais
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Datas de registro do estudo
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Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
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Atualizações de registro de estudo
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Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Dor
- Manifestações Neurológicas
- Doenças do Sistema Nervoso
- Complicações pós-operatórias
- Processos Patológicos
- Manifestações Neurocomportamentais
- Distúrbios Perceptivos
- Condições Patológicas, Sinais e Sintomas
- Sinais e sintomas
- Dor, Pós-operatório
- Agnosia
- Produtos químicos orgânicos
- Compostos heterocíclicos, 1 anel
- Compostos heterocíclicos
- Anilides
- Amidas
- Compostos de anilina
- Aminas
- Acetanilidas
- Piperidinas
- Fentanil
- Lidocaína
- Sufentanil
Outros números de identificação do estudo
- KYLL-202210-071-1
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