To investigate the effect of intravenous lidocaine on postoperative fatigue syndrome (POFS) in laparoscopic radical colorectal cancer surgery patients, a randomized controlled trial enrolled 86 patients aged over 18 with preoperative Christensen score ≤ 4 at Xuzhou Central Hospital from September 2023 to June 2024. The lidocaine group (group L) received an intravenous infusion of 1.5 mg·kg of lidocaine for 15 min, 30 min prior to anesthetic induction, followed by sustained infusion at 1.5 mg·kg·h until surgical closure. The control group (group C) received an equal volume of normal saline in the same manner. Compared with the group C, the time-weighted average (TWA) of Christensen score in the group L decreased by 0.42 (95% CI, 0.12 ~ 0.73, P < 0.05). Compared with the group C, the VAS at 1,3 and 5 days after surgery in the group L were lower (P < 0.05), the levels of IL-6 and TNF-α immediately after surgery and 24 h after surgery were lower (P < 0.05), and the time to first flatus and defecation was shorter (P < 0.05). No significant differences between the two groups in extubation time, PACU stay duration, incidence of postoperative nausea and vomiting (PONV), or length of postoperative hospital stay (P > 0.05). Results indicate that intravenous lidocaine effectively improved POFS in patients undergoing laparoscopic radical resection of colorectal cancer, which might be achieved by inhibiting the postoperative inflammatory response and reducing postoperative pain.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery •
Perioperative intravenous lidocaine infusion can improve the quality of recovery (QoR) in patients undergoing functional endoscopic sinus surgery (FESS), but the effect of esmolol on recovery has been rarely studied. The aim of this study to compare the effects of esmolol and lidocaine on the QoR in patients with FESS. A total of 60 patients were randomly divided into Group E: intravenous esmolol (0.5 mg/kg for 1 min, followed by 3.0 mg/kg/h); Group L: intravenous lidocaine (2.0 mg/ kg for 10 min, followed by 2 mg/kg/h). The quality of recovery-15 (QoR-15) score was compared. Other parameters compared were the numeric rating pain scale (NRS), haemodynamic data, Surgical field conditions, intraoperative drug dosages, number of cases of remedial analgesia, time to awakening and incidence of postoperative sore throat (POST) as well as postoperative nausea and vomiting (PONV). The mean difference in the QoR-15 score between Group E and Group L on postoperative day 1 (POD1) was - 1.37 (95% CI - 2.75 to 0.01; P < 0.001 for noninferiority), indicating the noninferiority of esmolol. Haemodynamic changes and intraoperative nitroglycerine dosages were significantly lower in Group E than in Group L (P < 0.05). The scores of surgical field quality (SSFQ) was higher in Group E than in Group L (P < 0.05). Intravenous infusion of esmolol is not inferior to lidocaine in the quality of postoperative recovery in patients with FESS, and is more advantageous in terms of the quality of the surgical field, attenuation of intraoperative haemodynamic fluctuations, and postoperative awakening.
The study aimed to explore the impact of transversus abdominis plane block (TAPB) combined with intravenous lidocaine on rapid recovery after bariatric surgery. A total of 80 patients who underwent elective bariatric surgery from October 2022 to October 2023 were selected as study participants and divided into a control group (CG) and a study group (SG). The CG received ultrasound-guided TAPB with ropivacaine, while the SG received ultrasound-guided TAPB with ropivacaine plus intravenous lidocaine. The two groups were compared in terms of total doses of propofol, remifentanil, and sufentanil used; pain intensity; intraoperative conditions; levels of inflammatory factors; additional use of postoperative analgesics; incidence of adverse reactions; and postoperative recovery time. Compared to the CG, the SG showed significant reductions in the total intraoperative doses of propofol, remifentanil, and sufentanil ( < 0.05). In addition, the SG had lower visual analog scale (VAS) scores at rest and during coughing at 12, 24, and 48 h postoperatively ( < 0.05), as well as lower heart rate (HR) and mean arterial pressure (MAP) values at time points T1-T3 ( < 0.05). On the first day after surgery, the levels of tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) in the SG were significantly lower than those in the CG ( < 0.05), and the SG also required less additional use of postoperative analgesics ( < 0.05). Furthermore, the SG exhibited a shorter time to first flatus, first defecation, and first ambulation, as well as a shorter length of hospital stay compared to the CG (all < 0.05). TAPB combined with intravenous lidocaine may provide effective postoperative analgesia for patients after bariatric surgery and may accelerate their rapid recovery.
Journal of anesthesia and translational medicine •
Postoperative sleep disturbance (POSD) caused by postoperative pain can impede the enhanced rapid recovery of elderly patients with colorectal cancer. We propose that perioperative intravenous lidocaine infusion may enhance postoperative sleep quality by alleviating postoperative pain in elderly patients undergoing laparoscopic radical resection for colorectal cancer. Sixty-three elderly patients were divided into two groups: the lidocaine group (group L) and the placebo group (group C). Patients in group L received intravenous injection of lidocaine 1.5 mg/kg during the induction of anesthesia, followed by lidocaine 1.0 mg kg h during surgery and for 24 h after surgery. Patients in group C received the same volume of normal saline. The primary outcome was postoperative sleep function, which was evaluated using the Athens Insomnia Scale (AIS). The secondary outcomes included the pain-at-rest and pain-on-movement of patients at 2, 4, 6, 12, 24, 48, and 72 h after surgery, opioid and propofol consumption, bowel function recovery time, postoperative complications, and lidocaine side effects. Compared to group C, AIS scores in group L were significantly lower on day 1 (12.9 ± 4.0 vs 10.6 ± 3.9, < 0.05), day 3 (8.6 ± 4.2 vs 6.2 ± 3.9, < 0.05), and 1 week (4.3 ± 3.1 vs 2.2 ± 2.5, < 0.05) after surgery. There were no significant differences in VAS scores between the two groups. The intraoperative consumption of propofol and remifentanil was significantly reduced in group L. Lidocaine infusion significantly shortened the recovery time of bowel function. There were no statistical differences between the two groups regarding the incidences of PONV and postoperative pulmonary complications. No cases of local anesthetic toxicity occurred in either group. Perioperative intravenous administration of lidocaine can facilitate the restoration of postoperative sleep function in elderly patients undergoing laparoscopic radical resection of colorectal cancer.