the Clinicaltrail of the Effection Which of Phrenic Block Using in Non-intubated Video-assisted Thoracoscopic Surgery

Study Overview
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Brief Summary
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Putting 80 patients divided into group S（non-intubated general anesthesia combine with Paravertebral blocks、surface spray anesthesia and Vagus block） and group D（non-intubated general anesthesia combine with Paravertebral blocks、surface spray anesthesia、Vagus block and Phrenic block）randomly,compare the volume of anesthetic and the number of increasing anesthetic during operation were compared between the two groups.If the date of group S greater than group D，it shows that the effect of anesthetic effect of group D is better than group S.

Detailed Description
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Put 80 patients divided into group S（non-intubated general anesthesia combine with Paravertebral blocks、surface spray anesthesia and Vagus block） and group D（non-intubated general anesthesia combine with Paravertebral blocks、surface spray anesthesia、Vagus block and Phrenic block）randomly. Compare the volume of anesthetic drugs between the two groups. If the date of group S greater than group D，it shows that the effect of anesthetic effect of group D is better than group S.

Official Title
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Department of Anesthesiology in Shenzhen People's Hospital

Conditions
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Phrenic Nerve Paralysis

Intervention / Treatment
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* Procedure: phrenic block
* Procedure: no phrenic block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The patient agreed to perform non-intubated video-assisted thoracoscopic surgery, and informed the possibility of intraoperative tracheal intubation or thoracotomy. No conventional anesthesia contraindication, no history of thoracic surgery, good cardiopulmonary function. There is no severe adhesion and calcification in the thoracic cavity, and no artificial pneumothorax is affected. the patient has no serious anxiety or depression. Small surgical trauma, simple steps, short time. Exclusion Criteria: Mallampati≥3. BMI≥26 kg/m2. Hemodynamic instability. INR≥1.5. Respiratory infection, persistent cough or airway mucus hypersecretion, high risk of reflux. nervous system disease,such as seizure or brain edema. Extensive pleural adhesions or once chest surgery. PaO2<60mmHg or PaCO2>50 mmHg. Central hypopnea syndrome. Lung isolation should be used to protect the healthy side of the lung. Complicated operation, large trauma, long time, lack of experience or poor cooperation in the surgical team. Contraindications to local anesthetic.

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: Put 80 patients divided into group S（non-intubated general anesthesia combine with Paravertebral blocks、surface spray anesthesia and Vagus block） and group D（non-intubated general anesthesia combine with Paravertebral blocks、surface spray anesthesia、Vagus block and Phrenic block）randomly. Compare the volume of anesthetic drugs between the two groups. If the date of group S greater than group D，it shows that the effect of anesthetic effect of group D is better than group S.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: phrenic block group<br>non-intubated general anesthesia combine with Paravertebral blocks、surface spray anesthesia、Vagus block and Phrenic block | Procedure: phrenic block<br>* phrenic block by 1% ropivacaine 5ml<br>|
| Active Comparator: Control group<br>non-intubated general anesthesia combine with Paravertebral blocks、surface spray anesthesia and Vagus block | Procedure: no phrenic block<br>* no phrenic block<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the volume of anesthetic drugs | the volume of anesthetic drugs including sevoflurane,propofol and opioids during the operation | the time of operation， an average of 4 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the time to get out of bed after surgery | note the time to get out of bed after surgery | two days after surgery | 
| the cost of hospitalization | note the the cost of hospitalization | the time of hospitalization， an average of 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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non-intubated general anaesthesia, video-assisted thoracoscopic surgery, phrenic block