University Department of Anaesthesiology and Pain Therapy, University Hospital, Bern, Switzerland.
Eur J Anaesthesiol. 2012 Nov;29(11):537-43. doi: 10.1097/EJA.0b013e328356bad6.
There is evidence that perioperative intravenous lidocaine administration can reduce analgesic requirement, improve recovery of bowel function and shorten the length of hospital stay. Its effect in laparoscopic renal surgery has not been investigated.
To evaluate the effect of systemic lidocaine on the length of hospital stay, readiness for discharge, opioid requirement, bowel function and inflammatory and stress response after laparoscopic renal surgery.
Randomised, double-blind, placebo-controlled study.
Single tertiary centre where the study was carried out between July 2009 and February 2011.
Sixty-four patients completed the study. Inclusion criteria were laparoscopic renal surgery and American Society of Anesthesiologists physical status I to III. Exclusion criteria were steroid therapy, chronic opioid therapy, allergy to lidocaine, pre-existing bowel dysfunction and arrhythmia.
Lidocaine was given as a 1.5 mg kg(-1) bolus during induction of anaesthesia, followed by an intraoperative infusion of 2 and 1.3 mg kg(-1) h(-1) for 24 h postoperatively. Primary outcome was the length of hospital stay. Secondary outcomes were readiness for discharge, opioid consumption, sedation, incidence of postoperative nausea and vomiting (PONV), return of bowel function and inflammatory and stress responses.
Length of hospital stay.
The length of hospital stay did not differ between the groups [6 days for the lidocaine group, interquartile range (IQR) 5 to 7, range 2 to 8 vs. 5 days for the placebo group, IQR 5 to 6, range 2 to 11; P = 0.24). Lidocaine had no effect on readiness for discharge [4 days for the lidocaine group (IQR 5 to 7, range 2 to 8) vs. 4 days for the placebo group (IQR 5 to 7, range 2 to 11); P = 0.26], opioid consumption, postoperative sedation, PONV, return of bowel function and plasma concentrations of C-reactive protein, procalcitonin and cortisol.
Systemic perioperative lidocaine administration over 24 h did not influence the length of the hospital stay, readiness for discharge, opioid consumption, return of bowel function or inflammatory and stress responses after laparoscopic renal surgery.
ClinicalTrials.gov identifier NCT00789620.
有证据表明，围手术期静脉内给予利多卡因可以减少镇痛需求，改善肠道功能恢复并缩短住院时间。但其在腹腔镜肾手术中的作用尚未得到研究。
评估全身利多卡因对腹腔镜肾手术后住院时间、出院准备、阿片类药物需求、肠道功能以及炎症和应激反应的影响。
随机、双盲、安慰剂对照研究。
该研究于 2009 年 7 月至 2011 年 2 月在一个单一的三级中心进行。
64 名患者完成了研究。纳入标准为腹腔镜肾手术和美国麻醉医师协会身体状况 I 至 III 级。排除标准为类固醇治疗、慢性阿片类药物治疗、对利多卡因过敏、预先存在的肠道功能障碍和心律失常。
麻醉诱导时给予 1.5mg/kg 的利多卡因负荷量，然后在术后 24 小时内输注 2mg/kg 和 1.3mg/kg/h。主要结局是住院时间。次要结局是出院准备、阿片类药物消耗、镇静、术后恶心和呕吐（PONV）的发生率、肠道功能恢复以及炎症和应激反应。
住院时间。
两组之间的住院时间无差异[利多卡因组 6 天，四分位距（IQR）5 至 7，范围 2 至 8 与安慰剂组 5 天，IQR 5 至 6，范围 2 至 11；P=0.24]。利多卡因对出院准备没有影响[利多卡因组 4 天（IQR 5 至 7，范围 2 至 8）与安慰剂组 4 天（IQR 5 至 7，范围 2 至 11）；P=0.26]、阿片类药物消耗、术后镇静、PONV、肠道功能恢复以及 C 反应蛋白、降钙素原和皮质醇的血浆浓度。
全身围手术期 24 小时内给予利多卡因不会影响腹腔镜肾手术后的住院时间、出院准备、阿片类药物消耗、肠道功能恢复或炎症和应激反应。
ClinicalTrials.gov 标识符 NCT00789620。
