Effect of General Anesthesia Combined Dexmedetomidine on Opioids Intraoperatively and Postoperatively in Patients With Lung Cancer Surgery

Study Overview
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Brief Summary
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Numerous studies in recent years have shown that the use of opioid-free analgesia can reduce opioid use and length of stay in the recovery room, as published in the journals Anesthesia & Analgesia1. Compared with traditional opioid analgesic anesthesia, opioid-free analgesic anesthesia can be used to reduce postoperative respiratory complications, postoperative nausea and vomiting, and postoperative opioid needs. During surgery, opioid analgesics may have immunosuppressive effects, but different anesthesia/analgesia methods will change the individual's stress response, affect the human body's cellular immunity, and may even lead to changes in angiogenesis growth factors associated with cancer recurrence, so it is likely to affect the prognosis of cancer patients. In addition, Dexmedetomidine, a highly selective alpha-2 adrenergic receptor agonist, can replace opioids for pain relief during surgery, providing superior analgesia and reducing opioid use while reducing the need for general anesthetics amount, thus avoiding suppression of immune system function. A study in the Journal of Anaesthesiology Clinical Pharmacology pointed out that Dexmedetomidine can be used to replace opioid analgesics in surgical anesthesia, and there was no difference in the use of rescue opioid analgesics during and after surgery5. Several clinical studies have shown that opioid-free anesthesia is significantly associated with a lower incidence of respiratory complications and postoperative nausea and vomiting. Therefore, general anesthesia combined with Dexmedetomidine can be regarded as an opioid-free anesthesia strategy.

Official Title
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Effect of General Anesthesia Combined Dexmedetomidine on Opioids Intraoperatively and Postoperatively in Patients With Lung Cancer Surgery

Conditions
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Opioid Use, Postoperative Pain

Intervention / Treatment
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* Drug: Dexmedetomidine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age older than 20 years old and younger than 75 years old Diagnosed as stage I-III non-small cell lung cancer Received video-assisted thoracoscopic lung wedge resection or lobectomy Exclusion Criteria: Cardiac arrhythmia , such as sinus bradycardia, sinus tachycardia, or high-degree atrioventricular block Diagnosed acute myocardial myocardial infarction, congestive heart failure, or stroke within one year Patient have underwent coronary artery bypass graft Allergy to drug such as Propofol, Sevoflurane, Dexmedetomidine, NSAID, Lidocaine)

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Total intravenous anesthesia (TIVA) + Dexmedetomidine<br>Total intravenous anesthetic drug is propofol. Dexmedetomidine is infused continuously. | Drug: Dexmedetomidine<br>* Initially give loading dose with 0.5 mcg/kg for 10 min and then keep maintenance dose with 0.5 mcg/kg/h until two-lung ventilation then 0.3 mcg/kg/h until the end of suture.<br>* Other names: Precedex;|
| No Intervention: Total intravenous anesthesia (TIVA)<br>Total intravenous anesthetic drug is propofol. The ordinary pain is controlled mainly by opioids. | |
| Experimental: Inhalation anesthesia plus Dexmedetomidine<br>Inhalation aneshetic drug is Sevoflurane. Dexmedetomidine is infused continuously. | Drug: Dexmedetomidine<br>* Initially give loading dose with 0.5 mcg/kg for 10 min and then keep maintenance dose with 0.5 mcg/kg/h until two-lung ventilation then 0.3 mcg/kg/h until the end of suture.<br>* Other names: Precedex;|
| No Intervention: Inhalation anesthesia<br>Inhalation aneshetic drug is Sevoflurane. The ordinary pain is controlled mainly by opioids. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The peri-operative dose of opioid | Calculate the total dose of opioid | up to three days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain scale | The pain scale will be assessed postoperatively | up to three days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dexmedetomidine, Opioid-free anesthesia, Non-small Cell Lung Cancer