Benefits of intravenous lidocaine on post-operative pain and acute rehabilitation after laparoscopic nephrectomy.
Benefits of intravenous lidocaine on post-operative pain and acute rehabilitation after laparoscopic nephrectomy.
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DOI：
10.4103/0970-9185.137269
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发表时间：
2014-07
期刊：
影响因子：
--
通讯作者：
Sztark F
中科院分区：
文献类型：
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作者：
Tauzin-Fin P;Bernard O;Sesay M;Biais M;Richebe P;Quinart A;Revel P;Sztark F
静脉注射（I. V.）利多卡因具有镇痛、抗痛觉过敏和抗炎的特性，并且已知可加速手术后肠功能的恢复。我们评估了静脉注射利多卡因对腹腔镜肾切除术后疼痛管理和急性康复方案的影响。共有47例计划接受腹腔镜肾切除术的患者被纳入一项两阶段观察性研究，在第二阶段，手术期间和术后24小时引入静脉注射利多卡因（1.5 mg/kg/h）。所有患者均接受相同的术后康复计划。术后疼痛评分，阿片类药物的消耗和痛觉过敏的程度进行了测量。记录首次排气时间和6 min步行试验（6 MWT）。两个阶段的患者人口统计数据相似（每组n = 22）。利多卡因显著减少吗啡消耗（中位数[25-75%四分位距]; 8.5 mg vs. 25 mg; P < 0.0001），术后疼痛评分（P < 0.05）和术后第1天、第2天、第4天的痛觉过敏程度（平均值±标准差（SD）;分别为1.5 ± 0.9 vs. 4.3 ± 1.2 cm（P < 0.001）、0.6 ± 0.5 vs. 2.8 ± 1.2 cm（P < 0.001）和0.13 ± 0.3 vs. 1.2 ± 1 cm（P < 0.001））。静脉注射利多卡因的患者第一次排气时间（平均值± SD; 29 ± 7 h vs. 48 ± 15 h; P < 0.001）和第4天的6 MWT（189 ± 50 m vs. 151 ± 53 m; P < 0.001）显著延长。静脉注射（I. V.）利多卡因可减少术后吗啡用量，改善腹腔镜肾切除术后疼痛管理和术后恢复。静脉注射利多卡因可能有助于更好的术后康复。
Intravenous (I.V.) lidocaine has analgesic, antihyperalgesic and anti-inflammatory properties and is known to accelerate the return of bowel function after surgery. We evaluated the effects of I.V. lidocaine on pain management and acute rehabilitation protocol after laparoscopic nephrectomy. A total of 47 patients scheduled to undergo laparoscopic nephrectomy were included in a two-phase observational study where I.V. lidocaine (1.5 mg/kg/h) was introduced, in the second phase, during surgery and for 24 h post-operatively. All patients underwent the same post-operative rehabilitation program. Post-operative pain scores, opioid consumption and extent of hyperalgesia were measured. Time to first flatus and 6 min walking test (6MWT) were recorded. Patient demographics were similar in the two phases (n = 22 in each group). Lidocaine significantly reduced morphine consumption (median [25-75% interquartile range]; 8.5 mg vs. 25 mg; P < 0.0001), post-operative pain scores (P < 0.05) and hyperalgesia extent on post-operative day 1-day 2-day 4 (mean ± standard deviation (SD); 1.5 ± 0.9 vs. 4.3 ± 1.2 cm (P < 0.001), 0.6 ± 0.5 vs. 2.8 ± 1.2 cm (P < 0.001) and 0.13 ± 0.3 vs. 1.2 ± 1 cm (P < 0.001), respectively). Time to first flatus (mean ± SD; 29 ± 7 h vs. 48 ± 15 h; P < 0.001) and 6MWT at day 4 (189 ± 50 m vs. 151 ± 53 m; P < 0.001) were significantly enhanced in patients with i.v. lidocaine. Intravenous (I.V.) lidocaine could reduce post-operative morphine consumption and improve post-operative pain management and post-operative recovery after laparoscopic nephrectomy. I.V. lidocaine could contribute to better post-operative rehabilitation.