Effect of Intravenous Lidocaine on Serum Interleukin-17 After Video-Assisted Thoracic Surgery for Non-Small-Cell Lung Cancer: A Randomized, Double-Blind, Placebo-Controlled Trial.
Effect of Intravenous Lidocaine on Serum Interleukin-17 After Video-Assisted Thoracic Surgery for Non-Small-Cell Lung Cancer: A Randomized, Double-Blind, Placebo-Controlled Trial.
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视频辅助胸腔手术治疗非小细胞肺癌后静脉注射利多卡因对血清白细胞介素 17 的影响：一项随机、双盲、安慰剂对照试验
DOI：
10.2147/dddt.s316804
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Ji FH
中科院分区：
文献类型：
--
作者：
Hou YH;Shi WC;Cai S;Liu H;Zheng Z;Qi FW;Li C;Feng XM;Peng K;Ji FH
目的手术应激促进肿瘤转移。白细胞介素 (IL)-17 在癌症进展中发挥着关键作用，IL-17 高表达预示着非小细胞肺癌 (NSCLC) 的不良预后。利多卡因可能发挥肿瘤抑制作用。我们假设静脉注射利多卡因可减轻非小细胞肺癌电视辅助胸腔手术 (VATS) 期间的手术应激并降低血清 IL-17 水平。方法 这项随机、双盲、安慰剂对照试验纳入了 60 名接受 VATS 的早期 NSCLC 患者，分为利多卡因组（n = 30；静脉推注利多卡因 1.0 mg/kg，1.0 mg/kg/h 直至手术结束）或生理盐水对照组（n = 30）。主要结果是术后24小时血清IL-17水平。次要结局包括麻醉后监护室（PACU）出院时的血清IL-17水平、PACU出院时和术后24小时的血清皮质醇水平、从PACU出院到术后48小时的疼痛评分（0-10）、术后0-48小时期间恶心呕吐、头晕和心律失常的发生率以及30天死亡率。长期结果包括化疗、癌症复发和死亡率。结果 与对照组相比，利多卡因组术后 24 小时血清 IL-17 较低（23.0 ± 5.8 pg/mL vs 27.3 ± 8.2 pg/mL，差异[95% CI] = −4.3 [−8.4 to −0.2] pg/mL；P = 0.038）。利多卡因组的血清IL-17（差异[95% CI] = -4.6 [-8.7至-0.5] pg/mL）、血清皮质醇（差异[95% CI] = -37 [-73至-2] ng/mL）和疼痛评分（差异[95% CI] = -0.7 [-1.3至-0.5] ng/mL）也降低。 -0.1]点）在PACU放电时。在中位随访10（IQR，9-13）个月期间，利多卡因组2名患者和对照组6名患者接受化疗，对照组1名患者出现癌症复发，无死亡事件发生。结论 早期 NSCLC 患者静脉注射利多卡因与 VATS 手术后血清 IL-17 和皮质醇降低相关。试用注册ChiCTR2000030629。
Purpose Surgical stress promotes tumor metastasis. Interleukin (IL)-17 plays a pivotal role in cancer progression, and high IL-17 expression predicts poor prognosis of non-small-cell lung cancer (NSCLC). Lidocaine may exert tumor-inhibiting effects. We hypothesize that intravenous lidocaine attenuates surgical stress and reduces serum IL-17 levels during video-assisted thoracic surgery (VATS) for NSCLC. Methods This randomized, double-blind, placebo-controlled trial included 60 early-stage NSCLC patients undergoing VATS, into a lidocaine group (n = 30; intravenous lidocaine bolus 1.0 mg/kg, and 1.0 mg/kg/h until the end of surgery) or a normal saline control group (n = 30). The primary outcome was serum IL-17 level at 24 hours postoperatively. The secondary outcomes included serum IL-17 level at the time of post-anesthesia care unit (PACU) discharge, serum cortisol level at PACU discharge and postoperative 24 hours, pain scores (0–10) from PACU discharge to 48 hours postoperatively, incidences of postoperative nausea and vomiting, dizziness, and arrhythmia during 0–48 hours postoperatively, and 30-day mortality. Long-term outcomes included chemotherapy, cancer recurrence, and mortality. Results The lidocaine group had lower serum IL-17 at 24 hours postoperatively compared with the control group (23.0 ± 5.8 pg/mL vs 27.3 ± 8.2 pg/mL, difference [95% CI] = −4.3 [−8.4 to −0.2] pg/mL; P = 0.038). The lidocaine group also had reduced serum IL-17 (difference [95% CI] = −4.6 [−8.7 to −0.5] pg/mL), serum cortisol (difference [95% CI] = −37 [−73 to −2] ng/mL), and pain scores (difference [95% CI] = −0.7 [−1.3 to −0.1] points) at PACU discharge. During a median follow-up of 10 (IQR, 9–13) months, 2 patients in the lidocaine group and 6 patients in the control group received chemotherapy, one patient in the control group had cancer recurrence, and no death event occurred. Conclusion Intravenous lidocaine was associated with reduced serum IL-17 and cortisol following VATS procedures in early-stage NSCLC patients. Trial Registration ChiCTR2000030629.