Despite the minimally invasive nature of video-assisted thoracoscopic surgery (VATS), moderate-to-severe postoperative pain remains frequent and impairs recovery. Intravenous lidocaine possesses multimodal analgesic, antihyperalgesic and anti-inflammatory properties that may improve pain control and functional outcomes, but robust evidence in thoracic surgery is lacking. Moreover, its potential to attenuate neuropathic pain, a key component of chronic post-thoracic pain syndromes, has not been adequately investigated. This trial will determine whether continuous perioperative intravenous lidocaine infusion improves recovery, reduces acute pain intensity and prevents the development of neuropathic pain after VATS. This single-centre, randomised, double-blind, placebo-controlled trial will enrol 84 adult patients undergoing elective VATS. Participants will be randomised (1:1) to receive either intravenous lidocaine (bolus 1 mg/kg at induction followed by continuous infusion at 1.5 mg/kg/hour intraoperatively and postoperatively for 24 hours) or matched normal saline postoperatively, with identical intraoperative management in both groups. The primary outcome is the incidence of moderate-to-severe movement-evoked pain at 24 hours postoperatively. Secondary outcomes include pain at 48 and 72 hours, opioid consumption, pulmonary complications, sleep quality, quality of recovery, neurocognitive outcomes and chronic neuropathic pain at 3 months. Analyses will follow the intention-to-treat principle. The study protocol was approved by the Institutional Review Board of Tongji Hospital (Reference No. TJ-IRB202509102) and registered in the Chinese Clinical Trial Registry (ChiCTR2500111163). Written informed consent will be obtained from all participants. Results will be submitted to peer-reviewed journals and academic conferences. ChiCTR2500111163.
Journal of anesthesia, analgesia and critical care •
Previous studies have demonstrated that perioperative use of lidocaine effectively reduces opioid requirements in various surgical procedures. Our objective was to evaluate the effect of postoperative intravenous lidocaine infusion on opioid consumption following pelvic bone tumor surgery. This single center randomized controlled trial in a tertiary teaching hospital containing a total of 70 patients, aged 18 to 65 years, with American Society of Anesthesiologists(ASA) physical status classifications of I to III, who were scheduled to undergo pelvic bone tumor surgery. Participants were randomly assigned in a 1:1 ratio to either the lidocaine group(L Group) or the control group(C Group). The L Group received lidocaine for postoperative analgesia, whereas the C Group was administered a placebo saline infusion.The primary outcome was postoperative opioid consumption. Secondary outcomes included the time to first bowel movement, the incidence of postoperative nausea and vomiting(PONV), and pain scores at rest and during movement on postoperative days. A significant difference was observed in the cumulative 72-h morphine equivalent consumption between the L Group (n = 33) and the C Group (n = 33). Patients in the L Group required significantly less morphine equivalent consumption compared to the C Group (13 (0-52) mg vs. 25 (14-85) mg, P = 0.043). Additionally, the proportion of patients experiencing breakthrough pain was significantly lower in the L Group compared to the C Group (33.33% vs. 75.76%, P = 0.001). No significant differences were noted between the groups in secondary outcomes, including the incidence of PONV, numerical pain scores at rest or during movement, time to first bowel evacuation, or time to first oral intake. Postoperative intravenous lidocaine infusion is effective in reducing opioid consumption and the incidence of breakthrough pain following pelvic bone tumor surgery. This single-center, prospective RCT was registered with the Chinese Clinical Trial Registry (ChiCTR2100051207, 15/09/2021). The first research participant was enrolled in September 20, 2021.
International journal of surgery (London, England) •
Lumbar surgery is often associated with significant postoperative pain, high opioid consumption, and delayed bowel function recovery. This study aimed to assess whether intravenous lidocaine infusion could enhance bowel function recovery in patients undergoing lumbar surgery. This multicenter, randomized, controlled, double-blinded study was conducted across three tertiary university hospitals. A total of 96 patients, aged 60-80 years, with an American Society of Anesthesiologists (ASA) classification of I-III, scheduled for lumbar spinal surgery, were randomly assigned to either the lidocaine group (L group) or the control group (C group) in a 1:1 ratio. Patients in the L group received perioperative intravenous lidocaine infusion and, postoperatively, lidocaine as a component of the multimodal patient-controlled analgesia regimen, whereas patients in the C group received normal saline in place of lidocaine under the same regimen. The primary outcome was the time to first evacuation. Secondary outcomes included the time to first defecation, intraoperative opioid consumption, incidence of postoperative nausea and vomiting (PONV), numerical rating scale (NRS) pain scores at rest and during movement, postoperative opioid consumption, and length of hospital stay. Patients in the L group had a significantly shorter evacuation time compared to the C group [(17 hours; 95% CI, 14-20 hours) vs (23 hours; 95% CI, 19-28 hours); P = 0.013)]. Intraoperative opioid consumption was significantly lower in the L group than in the C group, including sufentanil (18 [15, 20] µg vs. 25 [17, 30] µg, P < 0.001) and remifentanil (760 [450, 1040] µg vs. 1000 [760, 1440] µg, P = 0.002). Additionally, propofol usage was significantly lower in the L group compared to the C group (591.57 ± 206.39 mg vs. 692.96 ± 229.50 mg, P = 0.027). No significant differences were observed between the groups for other secondary outcomes. Intravenous lidocaine infusion in patients undergoing lumbar surgery accelerates postoperative bowel function recovery and reduces intraoperative opioid consumption.
This study aims to explore the analgesic effect of lidocaine administered through the hepatic artery during hepatic artery infusion chemotherapy (HAIC) for hepatocellular carcinoma (HCC). A total of 45 HCC patients were randomly divided into a study group and a control group. Both groups received oxaliplatin (OXA) based FOLFOX protocol via electronic infusion pump. The study group was continuously infused with 100 mg of lidocaine during HAIC, while 5% glucose solution was infused in the same way as described above. Changes in vital signs, visual analogue score (VAS) and general comfort score (GCQ scale) were recorded before surgery (Time point 0), at the end of infusion (Time point 01), 1 h after HAIC (Time point 02), 3 h after HAIC (Time point 03) and 6 h after HAIC (Time point 04). At each point of time from Time point 0 through Time point 04, the differences in MAP, RR and SPO between the two groups were not statistically significant ( > 0.05). At each point of time from Time point 01 through Time point 04, the mean VAS scores in the study group were smaller and GCQ scores were higher than those in the control group, and the differences were both statistically significant ( < 0.05). Lidocaine infusion through the hepatic artery during HAIC effectively reduces intraoperative and postoperative pain and improves patient satisfaction with pain management, making it a valuable technique for clinical practice.