Regional Haemodynamic Changes in Radial Artery Assessment With Continuous Pulsed-wave Doppler Ultrasound

Study Overview
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Brief Summary
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The objective of the trial was to evaluate velocity-associated parameters of pulsed-wave Doppler ultrasound at induction, discharge from the post-anaesthesia care unit and during inspiratory cough in addition to the consumption of phenylephrine during the operation in patients undergoing video-assisted thoracic surgery with three types of anaesthesia management.

Detailed Description
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The objective of the trial was to evaluate velocity-associated parameters of pulsed-wave Doppler ultrasound at induction, discharge from the post-anaesthesia care unit and during inspiratory cough in addition to the consumption of phenylephrine during the operation in patients undergoing video-assisted thoracic surgery with three types of anaesthesia management. The patients in this trial were visited during the entire operation and just before leaving the post-anaesthesia care unit. Velocity-associated data related to pulsed-wave Doppler ultrasound and the consumption of phenylephrine were collected.

Official Title
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Regional Haemodynamic Changes in Radial Artery Assessment With Continuous Pulsed-wave Doppler Ultrasound in Patients Undergoing Video-assisted Thoracic Surgery With Different Kinds of Anaesthesia Management

Conditions
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Lung Cancer

Intervention / Treatment
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* Drug: 0.5% ropivacaine paravertebral block
* Drug: 0.25% ropivacaine epidural block
* Drug: 0.5% ropivacaine local anaesthesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ethnic Chinese; age, 18 to 65 years old; American Society of Anaesthesiologists (ASA) physical status I or II; required VATS for lung surgery and one lung ventilation . Exclusion Criteria: body mass index exceeding 30 kg/m2; Patients with a history of hypertension, diabetes mellitus or arteriosclerosis; and any allergy to drugs used in the study. Patients with arrhythmias or implanted cardiac pacemakers were excluded. Patients with diseases of the central or peripheral nervous system were excluded. Patients taking medications affecting the autonomic nervous system, such as b-blockers and calcium channel blockers

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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
Interventional Model Description: Doppler Ultrasonography Assessed Vascular Changes
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Group control<br>In the control group, local anaesthesia at the incision was induced by 0.5% ropivacaine by the surgeon just before the surgery. | Drug: 0.5% ropivacaine local anaesthesia<br>* local anaesthesia at the incision was induced by 0.5% ropivacaine by the surgeon just before the surgery.<br>|
| Experimental: Paravertebral Block Group<br>In Group Paravertebral Block, patients received standardized general anaesthesia supplemented by paravertebral Block. The USG approach for TPVB was used with the patient in the lateral position at the T4-T6 level according to the incision protocol in our centre. | Drug: 0.5% ropivacaine paravertebral block<br>* The investigators designed a study to assess whether there were any blood flow indexes change during induction with doppler ultrasonography after 0.5% ropivacaine paravertebral block<br>|
| Experimental: Epidural Block Group<br>The investigators designed a study to assess whether there were any blood flow indexes change during induction with doppler ultrasonography ;general anesthesia combined with epidural block | Drug: 0.25% ropivacaine epidural block<br>* A 4-5 ml bolus of 0.25% ropivacaine was administered 1 h after the initiation of TEB.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Change of end-diastolic velocity | The primary outcome was the end-diastolic velocity at 12 time points of anaesthesia induction among the three groups. | baseline and 10 minutes after induction | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pulsed-wave Doppler ultrasound | other data related to pulsed-wave Doppler ultrasound and acquired during anaesthesia induction, before leaving the PACU and during inspiratory cough | before leaving the PACU, up to 5 minutes | 
| intraoperative consumption of phenylephrine | intraoperative consumption of phenylephrine | through study completion, an average of 3 hours |