Phrenic nerve block during nonintubated video-assisted thoracoscopic surgery: a single-centre, double-blind, randomized controlled trial

Zhu, Yi1,2,3; Wang, Guangsuo2,4; Gao, Wenli1,2; Lin, Miao1,2; Li, Yali1,2; Wang, Jiaqing2,4; Li, Guofeng2,4; Dai, Zhongliang1,2

2021-06-22

10.1038/s41598-021-92003-7

Scientific Reports   影响因子和分区

2045-2322

There has been interest in the use of nonintubated techniques for video-assisted thoracoscopic surgery (VATS) in both awake and sedated patients. The authors' centre developed a nonintubated technique with spontaneous ventilation for use in a patient under general anaesthesia using a phrenic nerve block. This treatment was compared with a case-matched control group. The authors believe that this technique is beneficial for optimizing anaesthesia for patients undergoing VATS. The patients were randomly allocated (1:1) to the phrenic nerve block (PNB) group and the control group. Both groups of patients received a laryngeal mask airway (LMA) that was inserted after anaesthetic induction, which permitted spontaneous ventilation and local anaesthesia in the forms of a paravertebral nerve block, a PNB and a vagal nerve block. However, the patients in the PNB group underwent procedures with 2% lidocaine, whereas saline was used in the control group. The primary outcome included the propofol doses. Secondary outcomes included the number of propofol boluses, systolic blood pressure (SBP), pH values of arterial blood gas and lactate (LAC), length of LMA pulled out, length of hospital stay (length of time from the operation to the time of discharge) and complications after 1 month. Intraoperatively, there were increases in lactate (F=12.31, P=0.001) in the PNB group. There was less propofol (49.20 +/- 8.73 vs. 57.20 +/- 4.12, P=0.000), fewer propofol boluses (P=0.002), a lower pH of arterial blood gas (F=7.98, P=0.006) and shorter hospital stays (4.10 +/- 1.39 vs. 5.40 +/- 1.22, P=0.000) in the PNB group. There were no statistically significant differences in the length of the LMA pulled out, SBP or complications after 1 month between the groups. PNB optimizes the anaesthesia of nonintubated VATS.

SCI

英语

通讯

Shenzhen Municipal Science and Technology Fund[JCYJ20170307100314152] ; Shenzhen Health Research Fund["SZLY2018011","SZXJ2017029"] ; Guangdong Medical Research Fund["A2018008","A2019382"] ; Scientific Research Fund of Shenzhen People's Hospital[SYLY201706]

Science & Technology - Other Topics

Multidisciplinary Sciences

WOS:000667448600008

NATURE RESEARCH

Web of Science

1.Jinan Univ, Shenzhen Peoples Hosp, Clin Med Coll 2, Dept Anesthesiol, Shenzhen 518020, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen 518020, Guangdong, Peoples R China
3.Huazhong Univ Sci & Technol, Yangtze Univ, Jingzhou Hosp,Dept Anesthesiol, Tongji Med Coll,Clin Med Coll 2,Jingzhou Cent Hos, Jingzhou 434020, Peoples R China
4.Jinan Univ, Shenzhen Peoples Hosp, Clin Med Coll 2, Dept Thorac Surg, Shenzhen 518020, Guangdong, Peoples R China

Zhu, Yi,Wang, Guangsuo,Gao, Wenli,et al. Phrenic nerve block during nonintubated video-assisted thoracoscopic surgery: a single-centre, double-blind, randomized controlled trial[J]. Scientific Reports,2021,11(1).

Zhu, Yi.,Wang, Guangsuo.,Gao, Wenli.,Lin, Miao.,Li, Yali.,...&Dai, Zhongliang.(2021).Phrenic nerve block during nonintubated video-assisted thoracoscopic surgery: a single-centre, double-blind, randomized controlled trial.Scientific Reports,11(1).

Zhu, Yi,et al."Phrenic nerve block during nonintubated video-assisted thoracoscopic surgery: a single-centre, double-blind, randomized controlled trial".Scientific Reports 11.1(2021).