Tubeless Anesthesia in Preventing Lung Complications in Patients Undergoing Surgery for Early-Stage Lung Cancer
Tubeless Anesthesia in Preventing Contralateral Lung Complications in Patients Undergoing Single-Port Thoracoscopic Surgery for Early-Stage Lung Cancer: A Single-Center, Prospective, Open-Label, Randomized Controlled Trial
Fujian Medical University Union Hospital
224 participants
May 25, 2025
INTERVENTIONAL
Conditions
Summary
The study focuses on evaluating the effectiveness and safety of tubeless anesthesia in single-port thoracoscopic surgery for early-stage lung cancer patients. Traditional anesthesia methods risk postoperative complications like lung injury and respiratory issues. Tubeless anesthesia preserves spontaneous breathing without tracheal intubation, potentially reducing these complications and enhancing recovery. The study aims to compare this technique with traditional methods, assessing its impact on contralateral lung complications, perioperative hemodynamics, complication rates, and recovery speed.
Eligibility
Inclusion Criteria6
- Age ≥18 years and ≤70 years;
- ECOG performance status score 0-1;
- Good cardiac and pulmonary function;
- Single or multiple peripheral lung nodules planned for single-port thoracoscopic surgery, with or without mediastinal lymph node dissection or sampling;
- Able to comply with the study visit schedule and other protocol requirements;
- Signed informed consent and voluntary participation in the study.
Exclusion Criteria10
- Obese patients (BMI \>30);
- Patients with difficult intubation or expected complex airway management;
- COPD patients with copious airway secretions;
- Patients with neurological dysfunction or who cannot cooperate while awake;
- Patients expected to have extensive pleural adhesions or with previous lung resection;
- Elderly and frail patients with severe hypoxia (PaO2 \<60 mmHg) or hypercapnia (PaCO2 \>50/55 mmHg);
- Previous induction chemotherapy or chemoradiotherapy;
- Intraoperative need to isolate the lung to prevent spillage and contamination of the contralateral lung;
- Patients expected to have large surgical wounds and lengthy procedures, clinically assessed as unsuitable;
- Patients whose cardiac and pulmonary function, or overall health, cannot withstand the procedure.
Interventions
1. Anesthesia Induction: Implement TCI with propofol and remifentanil; insert a laryngeal mask for SIMV ventilation, and monitor vital signs including IBP and end-tidal CO2. 2. Nerve Blocks: Perform ultrasound-guided paravertebral, pleural surface, and vagus nerve blocks using local anesthetics. 3. Anesthesia Maintenance: Adjust remifentanil for spontaneous breathing; maintain propofol and BIS levels; manage heart rate and blood pressure with fluids and medication as needed, without using inhaled anesthetics. 4. Postoperative Analgesia: Provide PCIA with morphine for pain management.
1. Anesthesia induction using propofol, sufentanil, and rocuronium is performed, with DLT or single-lumen tube insertion at BIS≤60 for single-lung ventilation, maintaining appropriate oxygen and ventilation parameters. 2. Anesthesia is maintained with sevoflurane, propofol, and remifentanil, supplementing rocuronium every 30-40 minutes for muscle relaxation, with BIS maintained at 40-60. 3. Post-surgery, ultrasound-guided thoracic paravertebral block and PCIA are used for analgesia, with extubation following standard recovery procedures.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07024433