Association between intraoperative intravenous lidocaine infusion and survival in patients undergoing pancreatectomy for pancreatic cancer: a retrospective study
Association between intraoperative intravenous lidocaine infusion and survival in patients undergoing pancreatectomy for pancreatic cancer: a retrospective study
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术中静脉注射利多卡因与因胰腺癌接受胰腺切除术的患者生存之间的关系：一项回顾性研究
DOI：
10.1016/j.bja.2020.03.034
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发表时间：
2020-08-01
影响因子：
9.8
通讯作者：
Miao, Changhong
中科院分区：
文献类型：
--
作者：
Zhang, Hao;Yang, Li;Miao, Changhong
背景：静脉注射利多卡因已被证明可以减少阿片类药物的消耗，并与手术后的良好结局相关。在这项研究中，我们探讨了术中利多卡因是否减少了术中阿片类药物的使用和住院时间（LOS），并提高了胰腺癌手术后的长期生存率。方法：这项回顾性研究包括2239例从2014年1月至2017年12月接受胰腺切除术的患者。将患者分为非利多卡因组和利多卡因组（麻醉诱导时推注1.5 mg kg（-1），术中持续输注2 mg kg（-1）h（-1））。记录两组患者术后镇痛药的使用情况和住院天数。倾向评分匹配被用来最大限度地减少偏差，无病生存期和总生存期进行了比较，两组之间。结果：经过倾向评分匹配，患者的特点没有显着差异组间。利多卡因组术中舒芬太尼用量和术后镇痛药用量均显著低于非利多卡因组。两组之间的LOS相似。两组间无病生存率无显著差异（风险比[HR]=0.913; 95%置信区间[CI]，0.821-1.612; P=0.316）。利多卡因组的1年和3年总生存率显著高于非利多卡因组（68.0%比62.6%，P
Background: Intravenous lidocaine has been shown to reduce opioid consumption and is associated with favourable outcomes after surgery. In this study, we explored whether intraoperative lidocaine reduces intraoperative opioid use and length of stay (LOS) and improves long-term survival after pancreatic cancer surgery.Methods: This retrospective study included 2239 patients who underwent pancreatectomy from January 2014 to December 2017. The patients were divided into non-lidocaine and lidocaine (bolus injection of 1.5 mg kg(-1) at the induction of anaesthesia followed by a continuous infusion of 2 mg kg(-1) h(-1) intraoperatively) groups. The overall use of postoperative rescue analgesia and LOS were recorded. Propensity score matching was used to minimise bias, and disease-free survival and overall survival were compared between the two groups.Results: After propensity score matching, patient characteristics were not significantly different between groups. Intraoperative sufentanil consumption and use of postoperative rescue analgesia in the lidocaine group were significantly lower than those in the non-lidocaine group. The LOS was similar between groups. There was no significant difference in disease-free survival between groups (hazard ratio [HR]=0.913; 95% confidence interval [CI], 0.821-1.612; P=0.316). The overall survival rates at 1 and 3 yr were significantly higher in the lidocaine group than in the non-lidocaine group (68.0% vs 62.6%, P