scholarly journals Effects of Transcutaneous Electrical Acupoint Stimulation on Stress Response during Intubation and Extubation in Patients Undergoing Video-Assisted Thoracoscopic Surgery: A Prospective, Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zhiyan Yu ◽  
Yuying Zhang ◽  
Huan Zhang ◽  
Xue Zhao ◽  
Hua Wei ◽  
...  
Keyword(s):  
Stress Response ◽  
Postoperative Complications ◽  
Thoracoscopic Surgery ◽  
Plasma Concentrations ◽  
Quality Score ◽  
Sedation Score ◽  
Control Group ◽  
Acupoint Stimulation ◽  
Video Assisted Thoracoscopic Surgery ◽  
Ramsay Sedation Score

Objective. The study aimed to evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the stress response during intubation and extubation in patients undergoing video-assisted thoracoscopic surgery (VATS). Methods. 122 patients undergoing VATS lobectomy were randomly divided into two groups: the TEAS group (n = 62) and the control group (n = 60). Patients in the TEAS group underwent electroacupuncture stimulation of bilateral Neiguan (PC6), Hegu (L14), Lieque (LU7), and Chize (LU5) acupoints from 30 min before anesthesia to the end of surgery. The patients in the control group did not undergo stimulation. The primary endpoints were the hemodynamic parameters and plasma concentrations of epinephrine, norepinephrine, and cortisol. The secondary endpoints were the consumption of remifentanil and propofol, Ramsay sedation score and arousal time, extubation quality score, and postoperative complications. Results. The hemodynamic variables and plasma concentrations of epinephrine, norepinephrine, and cortisol during intubation and extubation were lower in the TEAS group at T1, T3, and T4 compared with the control group. TEAS led to a reduction in the consumption of remifentanil ( P < 0.01 ), as well as a reduction in the incidence of postoperative complications. The extubation quality score was lower ( P < 0.01 ) while the Ramsay sedation score was higher ( P < 0.01 ) in the TEAS group than in the control group. However, the arousal time and consumption of propofol were not significantly different between the two groups. Conclusion. TEAS can maintain hemodynamic stability, reduce the stress response during intubation and extubation, improve the quality of anesthesia recovery, and decrease the incidence of postoperative complications in patients undergoing VATS.

Comparison of Subxiphoid and Intercostal Uniportal Thoracoscopic Thymectomy for Nonmyasthenic Early-Stage Thymoma: A Retrospective Single-Center Propensity-Score Matching Analysis

2020 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Disease Stage ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Video Assisted ◽  
Drainage Time ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective The aim of this study was to compare early outcome between intercostal uniportal video-assisted thoracoscopic surgery (IU-VATS) versus subxiphoid uniportal video-assisted thoracoscopic surgery (SU-VATS) in thymectomy for non-myasthenic early-stage thymoma. Method Retrospective analysis of 76 cases completed in our hospital from May 2018 to September 2019 with subxiphoid uniportal thoracoscopic thymectomy; a single incision of ∼3 cm was made ∼1 cm under the xiphoid process. The control group included 213 patients who received intercostal uniportal thoracoscopic thymectomy from August 2015, and propensity score matching was conducted. All patients who were clinically diagnosed with thymic tumor before surgery were treated with thymectomy. Perioperative outcomes between SU-VATS (n = 76) and IU-VATS, n = 76 were compared. Result After propensity score matching, there were no statistically significant differences between the two groups in terms of age, gender, disease stage, maximal tumor size, or other baseline demographic and clinical variables. All operation was successfully completed; there were no significant differences in the operative time (88 vs. 81 minutes, p = 0.63), intraoperative blood loss (55 vs. 46 mL, p = 0.47), postoperative drainage time (2.2 vs. 2.5 days, p = 0.72), and postoperative hospital stay (3.2 vs. 3.4 days, p = 0.78) between the two groups. The visual analog scale (VAS) on postoperative days 1, 3, 7, and 30 was less in the SU-VATS group than that in the IU-VATS group. The VAS on days 60 and 180 did not differ significantly between the two groups. Conclusion Thymectomy using SU-VATS is a feasible procedure; it might reduce early postoperative pain and lead to faster recovery.

scholarly journals Analysis on the Clinical Effect of High-Dose Glucocorticoids Combined with Immunosuppressants on Patients with Myasthenia Gravis Undergoing Video-Assisted Thoracoscopic Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Pei Liu ◽  
Haoyue Wang ◽  
Jiejie Hu ◽  
Xiaobin Zhai ◽  
Zhaoming Ge
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Efficacy ◽  
Clinical Effect ◽  
Clinical Symptoms ◽  
Thoracoscopic Surgery ◽  
Control Group ◽  
High Dose ◽  
Video Assisted ◽  
Experimental Group ◽  
Video Assisted Thoracoscopic Surgery

Objective. The purpose of the study was to investigate the clinical effect of high-dose glucocorticoids (GCS) combined with immunosuppressants on the treatment of myasthenia gravis (MG) with video-assisted thoracoscopic surgery (VATS). Methods. A total of 106 MG patients admitted to the neurology department of our hospital from February 2016 to February 2020 were selected as the study subjects and divided into experimental group ( n = 53 ) and control group ( n = 53 ). The patients in the control group underwent VATS, while the patients in the experimental group were treated with high-dose GCS combined with immunosuppressants on the basis of VATS treatment. The clinical efficacy of different MG treatment methods was analyzed. Results. No significant differences were observed in visual analogue score (VAS) at T1 between the two groups ( P > 0.05 ), while VAS scores at T2, T3, and T4 in the experimental group were significantly lower than those in the control group ( P < 0.001 ). In the experimental group, the overall response rate was significantly higher than the control group ( P < 0.05 ). Cytotoxic T-lymphocyte-associated protein 4 (CTLA4) level in regulatory T (Treg) cells in experimental groups after treatment was significantly higher, compared to that in before treatment and the control group ( P < 0.05 ). Similar results of each quantitative MG score were displayed in both groups after treatment, compared to before treatment and the control group ( P < 0.05 ). Clinical performance of patients with lower incidence of adverse reactions in the experimental groups after treatment was significantly higher than those in the control group ( P < 0.001 ). Conclusion. GCS combined with immunosuppressants can effectively relieve patients’ clinical symptoms and improve their quality of life, with significant clinical efficacy and high safety, which is worthy of application and promotion.

Video-assisted thoracoscopic surgery for lung cancer after induction therapy

2018 ◽  
Vol 26 (8) ◽  
pp. 608-614 ◽  
Author(s):  
Katsunari Matsuoka ◽  
Tetsu Yamada ◽  
Takahisa Matsuoka ◽  
Shinjiro Nagai ◽  
Mitsuhiro Ueda ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Postoperative Complications ◽  
Induction Therapy ◽  
Thoracoscopic Surgery ◽  
Locally Advanced ◽  
Advanced Lung Cancer ◽  
Video Assisted ◽  
Significant Difference ◽  
Locally Advanced Lung Cancer ◽  
Video Assisted Thoracoscopic Surgery

Background Although thoracoscopic surgery is widely performed for early-stage lung cancer, only a few small studies have evaluated the role of video-assisted thoracoscopic surgery in patients with locally advanced lung cancer who had received preoperative chemotherapy. Methods Among 1655 patients who underwent anatomical lung resection for lung cancer between January 2009 and December 2014 in our institution, we retrospectively examined the short- and long-term outcomes of 110 (6.6%) who had undergone induction therapy. Thoracoscopic surgery was performed in 79 of these patients and thoracotomy in 31. Results In the thoracoscopic group, conversion to a thoracotomy was required in 4 patients. More combined resections were included in the thoracotomy group, and combined resection of large vessels or the carina was carried out only via a thoracotomy. Postoperative complications of grade 3 or above were found in 15 (13.6%) patients, and there was no significant difference in the incidence of postoperative complications between the 2 groups. The 3- and 5-year survival rates for the patients overall were 58.6% and 50.3%, respectively. Although there was no significant difference in overall outcome between the 2 groups, the patients with postoperative ypN2 status in the thoracoscopic group had a significantly better outcome than those in the thoracotomy group. Conclusion Although video-assisted thoracoscopic surgery was not suitable for central advanced lung cancer requiring angioplasty or carinal resection, it seems to be useful for patients with locally advanced lung cancer who had undergone induction therapy, especially patients with peripheral lung cancer and mediastinal lymph node metastasis.

HEMODYNAMIC STRESS RESPONSE: ROLE OF AIRWAY NERVE BLOCK IN MICROLARYNGEAL SURGERIES

2019 ◽  
pp. 1-4
Author(s):  
Ranabir Chanda
Keyword(s):  
Stress Response ◽  
Mean Arterial Pressure ◽  
Postoperative Complications ◽  
Arterial Pressure ◽  
Nerve Block ◽  
Control Group ◽  
Block Group ◽  
Hemodynamic Stress ◽  
Group B ◽  
Microlaryngeal Surgery

Background: Microlaryngeal surgeries produce hemodynamic stress response which is manifested as rise of blood pressure and heart rateleading to harmful consequences, particularly in patientssuffering from signicant cardiovascular disorders. These hemodynamic changes can be attenuated by various drugs. No single drug is solely effective for this purpose. Aims: To observe the efcacy of airway nerve block in reducing hemodynamic stress response and postoperative complications following microlaryngeal surgery. Materials and methods: After obtaining approval from the Institutional Ethics Committee and written informed consent, 60 patients of either sex aged between 25 to 65 years of ASA physical status I undergoing microlaryngeal surgery were randomly allocated into two equal groups (group B and group C) with 30 patients in each group. Airway nerve block was performed in group B patients whereas airway nerve block was not administered in Group C patients. Subsequently microlaryngeal surgery was performed under general anaesthesia with controlled ventilation. Baseline and intraoperative heart rate, mean arterial pressure and postoperative complications were recorded. Results: Heartrateat 5,10and15 minutes was lowerinblockgroupbut not statistically signicant. However, heartrateat 30and45 minutes was signicantly lowerin block group. Mean arterial pressure was signicantly lowerin block group than control group at alltimeintervals.Nopostoperativelaryngospasm,bronchospasmanddesaturationwerefoundinblockgroup. Conclusion: Air way nerve block may be effective to prevent hemodynamic stress response and postoperative complications following microlaryngeal surgery

scholarly journals Observation on the Analgesic Effect of Bilateral Inferior Alveolar Nerve Block Combined With Parecoxib Sodium for Mandibular Orthognathic Surgery

2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Jie Lin
Keyword(s):  
Nerve Block ◽  
Orthognathic Surgery ◽  
Adverse Reactions ◽  
Inferior Alveolar Nerve ◽  
Sedation Score ◽  
Control Group ◽  
Inferior Alveolar Nerve Block ◽  
Intravenous Analgesia ◽  
Experimental Group ◽  
Ramsay Sedation Score

Background: To compare the analgesic effect and safety of bilateral inferior alveolar nerve block combined with parecoxib sodium analgesia and simple intravenous analgesia pump in analgesia after orthognathic surgery. Methods: Forty patients with simple ascending sagittal split osteotomy and ankle plasty were randomly divided into the experimental group and the control group, with 20 patients in each group. The experimental group received 2 ml 1% on both sides. Ropivacaine was treated with inferior alveolar nerve block anesthesia. Immediately after surgery, parecoxib sodium 40 mg was intravenously administered. The control group was given an intravenous analgesia pump for analgesia. Pain intensity (VAS pain score) and Ramsay sedation score were recorded at 2h, 4h, 8h, 24h, 48h after operation, and the incidence of postoperative adverse reactions was observed. Results: There was no significant difference in pain intensity and Ramsay sedation score between the two groups at each time point (P>0.05). During the analgesic treatment, the incidence of nausea and vomiting (P=0.046) in the experimental group was significantly lower than that in the control group (P<0.05). Conclusion: Bilateral inferior alveolar nerve block combined with parecoxib sodium analgesia and simple intravenous analgesia pump are effective for analgesia after mandibular orthognathic surgery, but the incidence of adverse reactions is significantly lower, more suitable for Analgesia after mandibular orthognathic surgery.

Efficacy of Pregabalin as preemptive analgesic in laparoscopic cholecystectomy

2020 ◽  
Vol 5 (3) ◽  
pp. 1166-1170
Author(s):  
Ajay Singh Thapa ◽  
Rajesh K Yadav
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Sedation Score ◽  
Preemptive Analgesia ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Post Operative Period ◽  
The Mean ◽  
Ramsay Sedation Score

Introduction: Different pharmacological approach for preemptive analgesia have been tried with varying degree of success. Preemptive analgesia results in decrease in postoperative opioid requirement and hence decreases opioid related complication. Objectives: This study aims to evaluate pregabalin as preemptive analgesic in scheduled cases. Methodology: Fourty ASA I and II  patients posted for elective laparoscopic cholecystectomy under general anesthesia were divided into two groups of twenty. Group A received pregabalin 300 mg, two hours before induction of anesthesia but group B were not given any medication. Postoperative VAS Score, Ramsay Sedation Score, postoperative nausea and vomiting and postoperative opioid requirement in two groups were observed over 48 hours and noted.Results: The mean VAS scores were  higher in control group whereas the mean Ramsay score was higher in group pregabalin in the first six hours in the post operative period which was statistically significant. The mean Ramsay sedation score was same (2) in both the group after twelve post operative period. Postoperative nausea and vomiting was lower in the pregabalin group. Requirement of post operative analgesia was higher in the control group. Conclusion: Preemptive use of Pregabalindecreasespostoperateive pain, postoperative opioid requirement and increases postoperative sedation.

Subxiphoid versus intercostal uniportal video-assisted thoracoscopic surgery for bilateral lung resections: a single-institution experience

2019 ◽  
Author(s):  
Haomin Cai ◽  
Dong Xie ◽  
Samer Al Sawalhi ◽  
Lei Jiang ◽  
Yuming Zhu ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Tube Placement ◽  
Lung Lesions ◽  
Video Assisted ◽  
Bilateral Lung ◽  
Lung Resections ◽  
Video Assisted Thoracoscopic Surgery

Abstract OBJECTIVES Subxiphoid uniportal video-assisted thoracoscopic surgery (SUVATS) is a technically difficult and challenging operation that can help decrease pain around the incision after traditional intercostal uniportal video-assisted thoracoscopic surgery (IUVATS), and can also treat bilateral lesions through the same incision. We aimed to compare perioperative outcomes and pain scores after SUVATS and IUVATS in patients receiving synchronous treatment of bilateral lung lesions. METHODS Patients who received SUVATS and IUVATS bilateral lung resections from September 2014 to February 2018 were analysed. Ultimately a total of 381 cases were analysed after using one-to-one propensity score matching to match baseline characteristics between the 2 groups. RESULTS The 381 patients included 56 with SUVATS and 325 with IUVATS. After matching, 54 SUVATS and 54 IUVATS cases were analysed. The 2 groups had similar preoperative factors and did not differ with respect to duration of chest tube placement, length of stay in hospital and incidence of postoperative complications. SUVATS was associated with a significantly longer operative time (212.3 vs 154.6 min, P < 0.001) and more blood loss (190.9 vs 72.7 ml, P < 0.001), lower pain score on the first day after operation (2.6 vs 3.0, P = 0.03) and before discharge (0.8 vs 1.4, P < 0.001). Furthermore, less patients in group SUVATS requested for additional analgesic therapy (P = 0.03). CONCLUSIONS Compared with IUVATS, despite the longer operative time and greater blood loss, SUVATS for bilateral lung lesions is a safe surgical procedure associated with significantly less postoperative pain and a similar incidence of postoperative complications in selected patients.

scholarly journals Comparison of video-assisted thoracoscopic surgery and standard surgical approach in treatment malignant thymus tumor stage I and II - propensity score analysis

2020 ◽  
Vol 148 (9-10) ◽  
pp. 548-553
Author(s):  
Vanja Kostovski ◽  
Milena Pandrc ◽  
Aleksandar Ristanovic ◽  
Dejan Stojkovic ◽  
Nebojsa Maric ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Propensity Score ◽  
Propensity Score Analysis ◽  
Thoracoscopic Surgery ◽  
Surgical Techniques ◽  
Perioperative Outcomes ◽  
Video Assisted ◽  
Thoracic Drainage ◽  
Significant Difference ◽  
Video Assisted Thoracoscopic Surgery

Introduction/Objective. Besides sternotomy, video-assisted thoracoscopic surgery (VATS) is used for thymus tumors treatment. The objective of our study was to compare oncological and perioperative outcomes in patients with I?II stage of thymic tumors treated with VATS or standard sternotomy procedures. Method. The study included only primary I?II thymoma according to the Masaoka classification, treated between May 2006 and February 2018. Out of 116 treated patients that had pathohistologically verified stage, 100 (86.2%) were matched by propensity score for sex, age, body mass index, myasthenia, tumor size, Masaoka classification stage. Oncological (direct post-operative survival, recurrence) and perioperative outcomes (intraoperative and postoperative complications, length of hospitalization) that affect the efficacy and safety of surgical techniques have been analyzed and compared between the two groups. Results. Among 50 patients operated by VATS, 34 patients (68%) were treated by uniportal approach, 13 (26%) by biportal and three (6%) by threeportal approach. The VATS intervention had shorter intervention time (p < 0.001), duration of hospitalization (p < 0.001), and usage of thoracic drainage (p < 0.001). There was a significant difference in terms of late control (p < 0.001). There was no significant difference between the groups regarding visual analogue scale score, as well as in terms of the time of recurrence (p = 0.305, p = 0.268). Conclusion. Compared to standard sternotomy, VATS thymectomy is an equally effective and significantly safer method with a minimum rate of intra and postoperative complications.

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