Atelectasis Clinical Trial
Official title:
Can Mini-dose Succinylcholine Accelerate Lung Collapse and Intrathoracic Nerve Blocks During Nonintubated Thoracoscopic Surgery? A Randomized Controlled Trial
A safe and effective surgical environment is important for nonintubated thoracoscopic surgery. The investigators hypothesize that mini-dose succinylcholine can induce ultra-short period of apnea, by which the ventilatory responses to open pneumothorax were abolished and may facilitate rapid and satisfying collapse of the operated lung during nonintubated thoracoscopic surgery.
Background: Nonintubated thoracoscopic surgery is the frontier of modern minimal invasive
thoracic surgery. A safe and effective surgical environment is established via an iatrogenic
open pneumothorax producing the operated lung fully collapsed. However, the initial
respiratory response to open pneumothorax is both tachypnea and carbon dioxide rebreathing,
which would jeopardize the quality of collapse of the operated lung and delay the performance
of intrathoracic vagal block. Intravenous opioid is effective to attenuate ventilatory
responses but herein with risk of persistent respiratory depression.
Methods: The investigators hypothesize that mini-dose succinylcholine 0.15 mg/kg can induce
ultra-short period of apnea, by which the ventilatory responses to open pneumothorax were
abolished and may facilitate rapid and satisfying collapse of the operated lung during
nonintubated thoracoscopic surgery. In a prospective, randomized, double-blind study design,
30 patients will be allocated to receive either succinylcholine (n=15) or placebo (n=15) in
the beginning of open pneumothorax. The effectiveness of succinylcholine will be measured by
the surgeon's evaluation of the quality of lung collapse, while the safety will be evaluated
by determination of arterial blood gases within 20 minutes of one-lung spontaneous breathing.
Expected results: Mini-dose succinylcholine can facilitate early lung collapse without
jeopardizing the ventilatory function during nonintubated thoracoscopic surgery with one-lung
spontaneous breathing, which may make nonintubated thoracoscopic surgery easier and safer.
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