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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:
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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| lidocaine | Experimental | Patients in this group will receive continuous lidocaine infusion via closed chest drainage tube. The pulse infusion speed is 1ml / 30min, and the continuous infusion speed was 2ml / h. |
|
| normal saline | Placebo Comparator | Patients in this group will receive continuous normal saline infusion via closed chest drainage tube. The pulse infusion speed is same as the lidocaine group. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lidocaine | Drug | After the thoracoscopic surgery, lidocaine will be transfused through the epidural tube fixed in the chest drainage tube was connected to an electronic pump whose parameters are already set up (marking the chest drain for analgesia). |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative pain score(NRS) | 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. In this study,the investigators mainly investigated the incidence of postoperative pain score was greater than 3 in each group. | Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in postoperative pain | 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. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jinying Zhang | Contact | 18560087707 | zhjydzx@163.com |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21857266 | Background | Abdallah FW, Brull R. Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? A systematic review. Reg Anesth Pain Med. 2011 Sep-Oct;36(5):493-8. doi: 10.1097/AAP.0b013e318228d5d4. | |
| 31474415 | Background | Barletta M, Reed R. Local Anesthetics: Pharmacology and Special Preparations. Vet Clin North Am Small Anim Pract. 2019 Nov;49(6):1109-1125. doi: 10.1016/j.cvsm.2019.07.004. Epub 2019 Aug 30. |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D008012 | Lidocaine |
| D000077330 | Saline Solution |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 |
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lidocaine will be injection by electronic analgesic pump, and the pulse infusion speed is 1ml / 30min, and 2ml / h for continuous infusion
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| normal saline | Drug | After the thoracoscopic surgery, normal saline will be transfused through the epidural tube fixed in the chest drainage tube was connected to an electronic pump whose parameters are already set up (marking the chest drain for analgesia). |
|
| Day 2 |
| the use of flurbiprofen axetil | the amount of rescue analgesic drugs flurbiprofen axetil used | Day 3 |
| the use of dolantin | the amount of rescue analgesic drugs dolantin used | Day 3 |
| the use of opioids | total amount of opioid use within 48h after surgery | Day 2 |
| postoperative adverse events | the incidence of nausea, vomiting, and vertigo after surgery | Day 3 |
| the amount of postoperative wound drainage | total amount of fluid drained after surgery | Day 3 |
| C-reactive protein | The inflammatory marker of participants will be test after surgery | Day 1 |
| interleukin-6 | The inflammatory marker of participants will be test after surgery | Day 1 |
| postoperative delusion | The incidence of postoperative delusion. | Day 3 |
| drainage extraction | The time taken for the patient to remove the drain after surgery | up to 24 hours (before extubation) |
| ICU stay time | 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 | The probability of patients acquiring pulmonary complications after surgery. | Day 3 |
| hospital length of stay | 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 | The healing rate of drainage wound at 21 days after surgery. | Day 21 |
| readmission rate | The readmission rate of patients in one month after surgery. | Month 1 |
| 22822998 | Background | Becker DE, Reed KL. Local anesthetics: review of pharmacological considerations. Anesth Prog. 2012 Summer;59(2):90-101; quiz 102-3. doi: 10.2344/0003-3006-59.2.90. |
| 21513074 | Background | Camorcia M, Capogna G, Columb MO. Effect of sex and pregnancy on the potency of intrathecal bupivacaine: determination of ED(5)(0) for motor block with the up-down sequential allocation method. Eur J Anaesthesiol. 2011 Apr;28(4):240-4. |
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| 24918330 | Background | Choquet O, Noble GB, Abbal B, Morau D, Bringuier S, Capdevila X. Subparaneural versus circumferential extraneural injection at the bifurcation level in ultrasound-guided popliteal sciatic nerve blocks: a prospective, randomized, double-blind study. Reg Anesth Pain Med. 2014 Jul-Aug;39(4):306-11. doi: 10.1097/AAP.0000000000000095. |
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| 8489988 | Background | Elmas C, Atanassoff PG. Combined inguinal paravascular (3-in-1) and sciatic nerve blocks for lower limb surgery. Reg Anesth. 1993 Mar-Apr;18(2):88-92. |
| 27469381 | Background | Grape S, Kirkham KR, Baeriswyl M, Albrecht E. The analgesic efficacy of sciatic nerve block in addition to femoral nerve block in patients undergoing total knee arthroplasty: a systematic review and meta-analysis. Anaesthesia. 2016 Oct;71(10):1198-209. doi: 10.1111/anae.13568. Epub 2016 Jul 29. |
| 26776715 | Background | Green SB. How Many Subjects Does It Take To Do A Regression Analysis. Multivariate Behav Res. 1991 Jul 1;26(3):499-510. doi: 10.1207/s15327906mbr2603_7. |
| 20167584 | Background | Gupta PK, Pace NL, Hopkins PM. Effect of body mass index on the ED50 volume of bupivacaine 0.5% for supraclavicular brachial plexus block. Br J Anaesth. 2010 Apr;104(4):490-5. doi: 10.1093/bja/aeq017. Epub 2010 Feb 18. |
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| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D010146 | Pain |
| Aniline Compounds |
| D000588 | Amines |
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |