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Postoperative cough after pulmonary resection is a common issue seen after thoracic surgeries, hindering patients' recovery and affecting their postoperative quality of life. While vagus nerve pulmonary branch block has been known to reduce intraoperative coughing, its impact on postoperative cough post lung resection is uncertain. This study aims to assess the effects of vagus nerve pulmonary branch block on postoperative cough after VATS lung resection. A randomized controlled trial involving 104 thoracoscopic lung resection patients will assign them randomly to a vagus nerve pulmonary branch block group or a control group. The primary outcome measure is the postoperative cough incidence 3 weeks after lung resection. The secondary outcomes include assessing hoarseness in PACU, peak expiratory flow (PEF) on the first post-op day, NRS scores for cough, and LCQ-MC scores at 3 weeks post-surgery, as well as cough occurrence, NRS scores, and LCQ-MC scores at 8 weeks post-procedure.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vagus nerve pulmonary branch block group (V group) | Experimental | After thoracotomy, under direct thoracoscopic visualization, 2.5 ml of 0.375% ropivacaine was injected in proximity to the main trunk of the pulmonary branches of the vagus nerve. |
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| Control group (C group) | Placebo Comparator | After thoracotomy, under direct thoracoscopic visualization, 2.5 ml of normal saline was administered in the vicinity of the principal trunk of the pulmonary branches of the vagus nerve. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vagus Nerve Pulmonary Branch Block | Procedure | Following thoracotomy, the thoracic surgeon, under direct thoracoscopic guidance, used forceps to elevate the apex of the lung, thus exposing the main trunk of the pulmonary branches of the vagus nerve. The injection needle was then advanced from a lateral-to-medial direction, and 2.5 ml of 0.375% ropivacaine was administered in close proximity to the targeted vagal branch. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of postoperative cough following lung resection at 3 weeks post-operation | The incidence of post-lung resection cough was assessed at 3 weeks postoperatively. | at 3 weeks post-operation |
| Measure | Description | Time Frame |
|---|---|---|
| Condition of hoarseness in PACU | Assessment of hoarseness in PACU following surgery | during in PACU, an average of 1 hour |
| Peak expiratory flow rate on postoperative day 1 | Measurement of peak expiratory flow on postoperative day 1 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lina Yu, doctor | Contact | +8613958033387 | zryulina@zju.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Second affiliated Hospital School of Medicine,Zhejiang University | Recruiting | Hangzhou | Zhejiang | China |
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| Vagus Nerve Pulmonary Branch Injection | Procedure | Following thoracotomy, the thoracic surgeon, under direct thoracoscopic guidance, used forceps to elevate the apex of the lung, thus exposing the main trunk of the pulmonary branches of the vagus nerve. The injection needle was then advanced from a lateral-to-medial direction, and 2.5 ml of normal saline was administered in close proximity to the targeted vagal branch. |
|
| on postoperative day 1 |
| Numerical Rating Scale for cough intensity at 3 weeks post-operation | The scale ranges from 0 to 10, with 0 indicating no cough and 10 representing the worst imaginable cough.Higher scores on the Numerical Rating Scale for cough intensity indicate a more severe cough condition. | at 3 weeks post-operation |
| Leicester Cough Questionnaire for Measuring Chronic Cough at 3 weeks post-operation | The LCQ-MC score ranges from a minimum of 0 to a maximum of 21, with three dimensions: physical, psychological, and social. Each dimension is scored from 1 to 7, and the total score is the sum of the three dimensions.Higher scores on the LCQ-MC indicate better health-related quality of life. A score of 0 represents the worst possible quality of life, while a score of 21 represents the best possible quality of life in relation to cough. | at 3 weeks post-operation |
| Incidence of postoperative cough following lung resection at 8 weeks post-operation | The incidence of post-lung resection cough was assessed at 8 weeks postoperatively. | at 8 weeks post-operation |
| Numerical Rating Scale for cough intensity at 8 weeks post-operation | The scale ranges from 0 to 10, with 0 indicating no cough and 10 representing the worst imaginable cough.Higher scores on the Numerical Rating Scale for cough intensity indicate a more severe cough condition. | at 8 weeks post-operation |
| Leicester Cough Questionnaire for Measuring Chronic Cough at 8 weeks post-operation | The LCQ-MC score ranges from a minimum of 0 to a maximum of 21, with three dimensions: physical, psychological, and social. Each dimension is scored from 1 to 7, and the total score is the sum of the three dimensions.Higher scores on the LCQ-MC indicate better health-related quality of life. A score of 0 represents the worst possible quality of life, while a score of 21 represents the best possible quality of life in relation to cough. | at 8 weeks post-operation |
| ID | Term |
|---|---|
| D000096822 | Chronic Cough |
| ID | Term |
|---|---|
| D003371 | Cough |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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