术中输注利多卡因对妇科腹腔镜手术患者术后疼痛和恢复质量的影响：一项随机对照试验

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术中输注利多卡因对妇科腹腔镜手术患者术后疼痛和恢复质量的影响：一项随机对照试验

贵州医科大学    麻醉与心脏电生理课题组

翻译：乔家康 编辑：潘志军  审校：曹莹

背景和目的：静脉注射利多卡因具有抗炎和镇痛作用，可减少术后疼痛、恶心、呕吐、术后肠梗阻的发生和减少住院时间，可能成为促进妇科腹腔镜手术后恢复的有用辅助药物。

材料与方法：选取18-55岁妇科腹腔镜手术女性患者50例，随机分为两组。L组患者在麻醉诱导时静脉注射利多卡因1.5 mg/kg，随后静脉注射2 mg/kg/h，直到手术结束;NS组患者静脉注射生理盐水。评估术后24小时QoR - 40评分、PACU和24小时疼痛评分、恶心/呕吐、PACU PADSS评分（麻醉后出院评分系统）和24小时镇痛消耗量，并使用SPSS version 17软件进行数据分析。

结果：两组数据具有可比性。L组QoR - 40评分平均值为197.30±2.3,NS组为178.74±6.02 (P < 0.001)。L组达到PADSS≥9的平均时间比NS组缩短50 min (P < 0.001)。与NS组相比，L组的恶心、呕吐发生例数以及需要止吐的例数显著减少(P = 0.005)， 24小时内的平均疼痛评分(P < 0.001)和术后24小时内的总镇痛用量也显著减少(P < 0.005)。

结论：术中静脉注射利多卡因可提高妇科门诊手术患者的整体康复质量。

原始文献来源：

Awal S, Bhalotra AR, Sharma S. Effects of intra-operative infusion of lidocaine on postoperative pain and quality of recovery in patients undergoing gynecological laparoscopic surgery: A randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2022 Apr-Jun;38(2):300-308.

  英文原文

Effects of intra-operative infusion of lidocaine on postoperative pain and quality of recovery in patients undergoing gynecological laparoscopic surgery: A randomized controlled trial

Abstract

Background and aims:Early recovery is desirable after day care surgery. Intravenous lidocaine has anti-inflammatory, anti-hyperalgesic, and analgesic effects and by reducing postoperative pain, nausea, vomiting, and duration of postoperative ileus and hospital stay, might be a useful adjuvant to improve recovery after gynecological laparoscopic surgery.

Material and methods:Fifty female patients, aged 18-55 years, undergoing gynecological laparoscopic surgery were randomly allocated to two groups. In Group L, patients received intravenous lidocaine 1.5 mg/kg at induction of anesthesia followed by infusion of 2 mg/kg/hour until the completion of surgery and in Group NS, patients received normal saline infusion. The Global QoR-40 score at 24 hours, pain score in PACU and at 24 hours, nausea/vomiting, PADSS score in PACU and analgesic consumption over 24 hours were assessed and data were analyzed using SPSS version 17 software.

Results:Demographic data were comparable in both groups. The mean Global QoR-40 score in Group L was 197.30 ± 2.3 versus 178.74 ± 6.02 in Group NS (P < 0.001). The mean time to attain PADSS ≥9 was 50 min shorter in Group L than in Group NS (P < 0.001). Nausea, vomiting, and anti-emetic requirement were also significantly reduced in Group L as compared to Group NS (P = 0.005) as was the mean pain score over 24 h (P < 0.001) and the total analgesic consumption over the first 24 h after surgery (P < 0.005).

Conclusion:Intraoperative intravenous lidocaine infusion resulted in an improved overall Quality of Recovery in patients undergoing ambulatory gynecological surgery.

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