The Effects of Intravenous Lidocaine Infusions on the Quality of Recovery and Chronic Pain After Robotic Thyroidectomy: A Randomized, Double-Blinded, Controlled Study
The Effects of Intravenous Lidocaine Infusions on the Quality of Recovery and Chronic Pain After Robotic Thyroidectomy: A Randomized, Double-Blinded, Controlled Study
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DOI：
10.1007/s00268-016-3842-1
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发表时间：
2017-05-01
影响因子：
2.6
通讯作者：
Lee, Jae Hoon
中科院分区：
文献类型：
--
作者：
Choi, Kwan Woong;Nam, Kee-Hyun;Lee, Jae Hoon
背景尽管利多卡因在术后具有镇痛效果，但其对术后恢复的影响尚未得到明确的研究。本随机、双盲、对照研究的目的是评估静脉注射利多卡因对机器人辅助甲状腺切除术后恢复质量和急性和慢性术后疼痛的影响。麻醉期间，患者接受2 mg/kg利多卡因，然后持续静脉输注3 mg/kg/h利多卡因（L组）或相同体积的0.9%生理盐水（C组）。术后2天，使用恢复质量-40问卷（QoR-40）评估急性疼痛特征和恢复质量。慢性术后疼痛（CPSP）和感觉障碍在手术部位进行了评估3个月后surgery.Results的QoR-40和疼痛评分，在2天内进行评估，手术后组之间在很大程度上是可比的。然而，C组中CPSP的患病率高于L组（16/43 vs. 6/41; p = 0.025）。术后3个月的触觉感觉评分在L组显著高于C组（7 vs. 5; p = 0.001）。结论全身利多卡因给药与机器人辅助甲状腺切除术后CPSP和感觉障碍的减少相关，尽管它不能减少急性术后疼痛或提高恢复质量。
Background The effect of the systemic lidocaine on postoperative recovery has not been definitively investigated despite its analgesic efficacy after surgery. The aim of this randomized, double-blinded, controlled study was to evaluate the effect of intravenously administered lidocaine on the quality of recovery and on acute and chronic postoperative pain after robot-assisted thyroidectomy.Methods Ninety patients who were undergoing robotic thyroidectomy were randomly assigned to the lidocaine or the control groups. The patients received 2 mg/kg of lidocaine followed by continuous infusions of 3 mg/kg/h of lidocaine (Group L) or the same volume of 0.9% normal saline (Group C) intravenously during anesthesia. The acute pain profiles and the quality of recovery, which was assessed using the quality of recovery-40 questionnaire (QoR-40), were evaluated for 2 days postoperatively. Chronic postsurgical pain (CPSP) and sensory disturbances at the surgical sites were evaluated 3 months after surgery.Results The QoR-40 and pain scores that were assessed during the 2 days that followed surgery were largely comparable between the groups. However, CPSP was more prevalent in the Group C than in the Group L (16/43 vs. 6/41; p = 0.025). The tactile sensory score 3 months after the operation was significantly greater in the Group L than in the Group C (7 vs. 5; p = 0.001).Conclusion Systemic lidocaine administration was associated with reductions in CPSP and sensory impairment after robot-assisted thyroidectomy although it was not able to reduce acute postsurgical pain or improve the quality of recovery.