Conditions: Arrhythmia, Cardiac Kidney Cancer Surgery Anesthesia, Local
Keywords: cardiac arrhythmia epidural anesthesia combined anesthesia general anesthesia NSS radical nephrectomy extraperitoneal
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 50
Healthy volunteers: no

Brief summary:
This study evaluates the incidence of cardiac arrhythmias during the perioperative period in patients undergoing open kidney cancer surgery in the lateral position. All the participants will be randomly allocated to receive general (Group G) or combined epidural/general anaesthesia (Group G/E). The anaesthetic technique is standardized. The Holter monitor will be applied at the evening before the surgery, tracing continuously for a period of 24 hours (7PM-7PM)

Detailed description:
Cardiac arrhythmias are a common complication during and after cardio-thoracic surgery. They are also a major source of morbidity and mortality. After general surgery, they usually do not require clinically significant management but the literature on this topic is obsolete. There is no literature data about their incidence during kidney surgery in the lateral position when the bed is scissored so the legs and head are low. The aim of this study was to define what types of arrhythmias are the most common during kidney cancer surgery, their incidence and whether combining general with epidural anesthesia prevents them.

An approval from the Medical University of Warsaw Bioethical Committee has been obtained. Patients need to give written informed consent to participate in the study.

It is anticipated that 50 patients with open kidney cancer surgery performed in the lateral position, under general or combined anesthesia will be enrolled.

A Holter ECG monitor (3-chanel, leads CM5) will be applied at the evening before the surgery, tracing continuously for a period of 24 hours (7PM-7PM).

Patients will be randomly allocated (random permuted blocks within strata) to receive general or combined epidural/general anesthesia. The anesthetic technique is standardized. All the data registered by the Holter ECG monitor will be analyzed and compared with the nursery and anesthesia records.

Arms:
arm 1: Holter ECG monitor General anesthesia Open kidney cancer surgery arm 2: Holter ECG monitor Epidural anesthesia General anesthesia Open kidney cancer surgery

Interventions: intervention 1: Bupivacaine-fentanyl intervention 2: Holter ECG monitor intervention 3: Open kidney cancer surgery intervention 4: General anesthesia intervention 5: Epidural Anaesthesia
Intervention descriptions: intervention 1: Local anesthetic intervention 2: 3-chanel, CM5 leads intervention 3: Lateral position intervention 4: None intervention 5: None

Protocol document: