Clinical trial NCT05341375: Effects of Thoracic Paravertebral Block Combined With S-ketamine on Postoperative Pain and Cognitive Function After Thoracoscopic Surgery
Official title: Effects of Thoracic Paravertebral Block Combined With S-ketamine on Postoperative Pain and Cognitive Function After Thoracoscopic Surgery
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Postoperative Cognitive Dysfunction
Keywords: Esketamine
Thoracic paravertebral block
Cognitive function
Lead sponsor: The First Hospital of Qinhuangdao
Sponsor class: OTHER_GOV
First posted: 2022-04-22
Enrollment: 110
Sex: ALL
Minimum age (years): 45
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: PREVENTION

Brief summary: To investigate the effect of ultrasound-guided thoracic paravertebral nerve block combined with intraoperative infusion of s-ketamine on postoperative acute pain and cognitive function in patients with thoracoscopic surgery

Detailed description: A total of 120 patients who were admitted to Qinhuangdao First Hospital for and divided into control group (group C ), thoracic paravertebral nerve block combined with full Anesthesia group (group TA), thoracic paravertebral nerve block combined with intraoperative infusion of s-ketamine group ( group TE). 40 cases in each group. Group C received general anesthesia, group TA received 0.375% ropivacaine 20ml thoracic paravertebral nerve block combined with general anesthesia under ultrasound guidance after anesthesia induction, and group TE received s-ketamine anesthesia induction dose of 0.3 mg/kg on the basis of TA group. Anesthesia maintenance dose of 0.2ug/kg/h was pumped to 30min before the end of the operation. The MAP(Mean Artery Pressure) and HR(Heart Rate) of the three groups were recorded before surgery (T1), during the surgery (T2), immediately after surgery (T3). Compare the VAS（Visual analogue scale）in the ten minuses after extubation and one day afte surgery .The cognitive function of the three groups were evaluated by the Mini Mental State Scale (MMSE) on one day before surgery , one day after surgery , and three months after surgery . Compare the incidence of Postoperative Cognitive Disfuntion（ POCD） among the three groups.

Eligibility criteria: Inclusion Criteria:

* 18-24kg/m2
* American Society of Anesthesiologists (ASA) grades I-III
* The score of Mini Mental state examination≥24

Exclusion Criteria:

* Patients with heart, lung and other vital organ disorders
* The score of Mini Mental state examination≤23
* Preoperative psychiatric disorders or long-term use of drugs affecting the psychiatric system
* Have severe visual, hearing, speech impairment or other inability to communicate with the visitor
* Refuse to sign informed consent

Primary outcomes:
measure: Incidence of POCD at one day after surgery
timeFrame: One day after surgery
measure: Incidence of POCD at three months after surgery
timeFrame: Three months after surgery
measure: Change in pain assessed by Visual Analogue Scale
timeFrame: Ten minutes after extubation
measure: Change in pain assessed by Visual Analogue Scale
timeFrame: One day after surgery
Secondary outcomes:
measure: Anesthetic drug
timeFrame: during the surgery
measure: The change of MAP
timeFrame: pre-surgery;during the surgery;immediately after surgery
measure: The change of HR
timeFrame: pre-surgery;during the surgery;immediately after surgery
Other outcomes:
Locations:
city: Qinhuangdao
country: China
facility: The First hosptial of Qinhuangdao
Study officials:
affiliation: The First hosptial of Qinhuangdao
name: PI liuqinshuang, master
role: STUDY_DIRECTOR
affiliation: The First hosptial of Qinhuangdao
name: chenxiaodan chenxiaodan, master
role: STUDY_CHAIR
References: