Lidocaine Reduces Acute Postoperative Pain After Supratentorial Tumor Surgery in the PACU: A Secondary Finding From a Randomized, Controlled Trial
Lidocaine Reduces Acute Postoperative Pain After Supratentorial Tumor Surgery in the PACU: A Secondary Finding From a Randomized, Controlled Trial
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DOI：
10.1097/ana.0000000000000230
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发表时间：
2016-10-01
影响因子：
3.7
通讯作者：
Han, Ruquan
中科院分区：
文献类型：
--
作者：
Peng, Yuming;Zhang, Wei;Han, Ruquan
背景：据报道，围手术期输注利多卡因可以减轻腹部手术后患者的疼痛；然而，还没有研究利多卡因对幕上肿瘤手术后急性疼痛的影响。麻醉诱导后静脉推注利多卡因1.5 mg/kg，然后以2 mg/kg/h的速度静脉滴注至手术结束，或给予等量生理盐水。记录术中不同时间点的平均动脉压、心率和脑电双频指数。患者在术后麻醉护理病房(PACU)用数字评分表(NRS)评估疼痛。结果：生理盐水组与利多卡因组的平均动脉压、心率、脑电双频指数在各时间点均无显著差异(P>；0.05)。高血压、心动过速、烦躁不安和小马的发生率在两组间无显著差异(P>；0.05)。利多卡因组PACU术后轻度疼痛(NRS为1~3分)的发生率低于生理盐水组(P=0.014)，离开PACU前NRS疼痛评分为0的患者明显多于利多卡因组。两组患者均无中、重度疼痛。结论术中输注利多卡因可显著降低PACU幕上肿瘤术后急性疼痛患者的比例。
Background: Perioperative lidocaine infusion has been reported to reduce postoperative pain in patients after abdominal surgery; however, no study has examined lidocaine's effect on acute postoperative pain after supratentorial tumor surgery.Methods: A total of 94 patients scheduled for supratentorial craniotomy were enrolled. Patients received either lidocaine through an intravenous bolus (1.5 mg/kg) after induction followed by infusion at a rate of 2 mg/kg/h until the end of surgery or the same volume of normal saline. Mean arterial blood pressure, heart rate, and bispectral index were recorded at different intraoperative time points. Patients were assessed for pain in the postoperative anesthesia care unit (PACU) by the numeric rating scale (NRS). Other complications including hypertension, tachycardia, dysphoria, and postoperative nausea and vomiting (PONV) were reported.Results: There was no significant difference between the normal saline and lidocaine group for mean arterial blood pressure, heart rate, and bispectral index at any time point (P > 0.05). There was no significant difference in the incidence of hypertension, tachycardia, dysphoria, and PONY between groups (P > 0.05). The incidence of mild pain (NRS between 1 and 3) after surgery in PACU was lower in lidocaine group than that in the normal saline group (P = 0.014); the number of patients with an NRS pain score of 0 before leaving the PACU was significantly greater in the lidocaine group. No patient in either group had moderate or severe pain.Conclusions: Intraoperative infusion of lidocaine significantly decreases the proportion of patients with acute pain after supratentorial tumor surgery in the PACU.