Objective: To explore the effect of lidocaine continuous infusion on the quality of postoperative recovery in patients undergoing video-assisted thoracoscopic surgery.
Methods: Ninety patients were selected to undergo video-assisted thoracoscopic surgery under elective general anaesthesia, 50 males and 40 females, aged 18-80 years, BMI 18.5-30.0 kg/m 2, and ASA physical status Ⅰ-Ⅲ. The patients were divided into two groups by random number table method: the lidocaine group (group L, n = 46) and the saline group (group C, n = 44). Group L was injected with 1.5 mg/kg of lidocaine slowly intravenously 10 minutes before induction of anaesthesia, and after intubation, it was pumped continuously at 2.0 mg·kg-1·h-1 until the end of the operation, while group C was infused with an equal amount of saline. Changes in HR and MAP before induction of anaesthesia, after induction, after intubation, after surgical skinning and after extubation, placement time of double lumen bronchial tube, intraoperative consumption of propofol and remifentanil, incidence of hypoxia during one-lung ventilation, time of awakening, time of stay in the PACU and length of postoperative hospital stay, and VAS pain scores at rest and activity 2, 6, and 12 hours after surgery were recorded. Quality of recovery (QoR-40) scores at 24 and 48 hours, the rate of postoperative remedial analgesia, incidence of nausea and vomiting, chills, delirium during PACU and incidence of nausea and vomiting 48 hours postoperatively, and incidence of pulmonary complications within 7 days postoperatively were recorded.
Results: Compared with group C, group L had significantly slower HR and lower MAP after intubation, skin incision and extubation (P < 0.05), significantly shorter double-lumen bronchial catheter placement, significantly lower intraoperative propofol and remifentanil consumption (P < 0.05), significantly shorter wake-up time and PACU stay (P < 0.05), significantly lower postoperative 2 and 6 hours resting VAS pain scores, and significantly lower postoperative 2 hour active VAS pain scores (P < 0.05), and significantly higher 24 and 48 hours QoR-40 total scores (P < 0.05), the rate of postoperative remedial analgesia was significantly lower (P < 0.05). There was no statistically significant difference in the incidence of nausea and vomiting, chills and delirium during the PACU and nausea and vomiting at 48 hours postoperatively between the two groups, and no statistically significant difference in the incidence of pulmonary complications within 7 days postoperatively.
Conclusion: The intravenous infusion of lidocaine during video-assisted thoracoscopic surgery results in improved postoperative recovery, characterised by more stable intraoperative haemodynamics, reduced intraoperative consumption of propofol and remifentanil, alleviation of postoperative pain, and expedited awakening and transfer to the ward. |
