静脉输注利多卡因对胸腔镜手术后恢复质量和镇痛效果的影响:一项随机对照试验

2021
04/07

+
分享
评论
米勒之声
A-
A+

目前研究结果不支持使用围手术期静脉使用利多卡因作为可改善VATS患者术后疼痛和提高QOR的潜在策略。




静脉输注利多卡因对胸腔镜手术后恢复质量和镇痛效果的影响:一项随机对照试验



研究目的

术中静脉使用利多卡因作为全身麻醉的辅助药物已被广泛接受,可减少阿片类药物的使用和促进恢复;我们假设胸腔镜手术(VATS)患者围手术期静脉输注利多卡因可改善术后疼痛并提高恢复质量(QOR)。

设计

前瞻性、单中心、双盲、随机、安慰剂对照临床试验。

范围设置

单一机构、医科大学三甲附属医院。

受试者

18-65岁接受VATS的成年患者有资格参加。

干预措施

本研究纳入的患者被随机分为两组;一组接受静脉使用利多卡因(静脉推注1.5mg/kg,然后以2mg/kg/h 持续泵注,直到手术结束),另一组接受相同体积和速度的0.9%生理盐水治疗。

观察指标

主要观察指标是观察术后24小时的QOR-15评分;次要指标包括术后疼痛评分、阿片类药物使用总量、苏醒时间、PACU停留时间、不良事件发生率和患者满意度。

主要结果

利多卡因组和生理盐水组术后24h的QOR-15评分差异无统计学意义(利多卡因组:中位数为117, 四分位间距(IQR)113.5–124;生理盐水组:中位数为116, IQR 111–120,P=0.067),中位数差异为3(95%CI为0-6,P=0.507)。同样,两组在术后疼痛评分、术后阿片类药物使用总量、PACU停留时间、PONV发生率和患者满意度方面均无显著性差异(为P>0.05)。

结论

目前研究结果不支持使用围手术期静脉使用利多卡因作为可改善VATS患者术后疼痛和提高QOR的潜在策略。

翻译:吴学艳  编辑:佟睿  审校:曹莹

READING


Efficacy of systemic lidocaine on postoperative quality of recovery and analgesia after video-assisted thoracic surgery: A randomized controlled trial


 

Study objective: Intraoperative systemic lidocaine has become widely accepted as an adjunct to general anesthesia, associated with opioid-sparing and enhanced recovery. We hypothesized that perioperative systemic lidocaine improves postoperative pain and enhances the quality of recovery (QoR) in patients following videoassisted thoracic surgery (VATS).


Design: Prospective, single-center, double-blind, randomized placebo-controlled clinical trial.


Setting: Single institution, tertiary university hospital.


Patients: Adult patients aged 18 to 65 undergoing VATS were eligible for participation.


Interventions: Patients enrolled in this study were randomized to receive either system lidocaine (a bolus of 1.5 mg kg÷ 1, followed by an infusion of 2 mg kg÷ 1 h⊃ 1 until the end of the surgical procedure) or identical volumes and rates of 0.9% saline.


Measurements: The primary outcome was a global QoR-15 score 24 h after surgery. Secondary outcomes included postoperative pain score, cumulative opioid consumption, emergence time, length of PACU stay, adverse events, and patient satisfaction.


Main results: There was no difference in the global QoR-15 scores at 24 h postoperatively between the lidocaine and saline groups (median 117, IQR 113.5–124, vs. median 116, IQR 111–120, P = 0.067), with a median difference of 3 (95% CI 0 to 6, P = 0.507). Similarly, postoperative pain scores, postoperative cumulative opioid

consumption, PACU length of stay, the occurrence of PONV, and patient satisfaction were comparable between the two groups (all P > 0.05).


Conclusions: Our current findings do not support using perioperative systemic lidocaine as a potential strategy to improve postoperative pain and enhance QoR in patients undergoing VATS.


本文由作者自行上传,并且作者对本文图文涉及知识产权负全部责任。如有侵权请及时联系(邮箱:nanxingjun@hmkx.cn
关键词:
胸腔镜,阿片类,手术,镇痛,试验,差异,药物

人点赞

收藏

人收藏

打赏

打赏

我有话说

0条评论

0/500

评论字数超出限制

表情
评论

为你推荐

推荐课程


社群

精彩视频

您的申请提交成功

确定 取消
剩余5
×

打赏金额

认可我就打赏我~

1元 5元 10元 20元 50元 其它

打赏

打赏作者

认可我就打赏我~

×

扫描二维码

立即打赏给Ta吧!

温馨提示:仅支持微信支付!