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静脉内给予利多卡因和镁在女性甲状腺手术中以改善麻醉后恢复质量。

Intravenously Administered Lidocaine and Magnesium During Thyroid Surgery in Female Patients for Better Quality of Recovery After Anesthesia.

机构信息

From the Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

Department of Anesthesiology and Pain Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.

出版信息

Anesth Analg. 2018 Sep;127(3):635-641. doi: 10.1213/ANE.0000000000002797.

Abstract

BACKGROUND

Although systemic lidocaine and magnesium have been widely studied as perioperative analgesic adjuvants, they have been rarely evaluated with respect to recovery quality under the same conditions. We compared the quality of recovery 40 (QoR-40) scores of female patients who received intravenous lidocaine, magnesium, and saline during thyroidectomy to investigate their effects on comprehensive recovery from anesthesia.

METHODS

In this prospective, double-blind trial, 135 female patients scheduled for open thyroidectomy were randomly assigned to the lidocaine group (group L), magnesium group (group M), or control group (group C). Immediately after induction, lidocaine (2 mg/kg for 15 minutes followed by 2 mg/kg/h) was administered in group L and magnesium sulfate (20 mg/kg over 15 minutes followed by 20 mg/kg/h) was administered in group M. Group C received an equivalent volume of saline. The QoR-40 survey was conducted on postoperative days 1 and 2.

RESULTS

The mean global QoR-40 scores on postoperative day 1 were 186.3 (standard deviation, 5.5) in group L, 184.3 (4.7) in group M, and 179.4 (17.8) in group C, and there was a significant difference only between group L and group C (mean difference, 6.9; adjusted P = .018). Among the 5 dimensions of QoR-40, emotional state, physical comfort, and pain were superior in group L compared to group C.

CONCLUSIONS

Lidocaine administered intravenously during anesthesia led to better quality of postoperative recovery measured by QoR-40 compared with the group C. Magnesium was found to be insufficient to induce any significant improvement with the dose used in the present study.

摘要

背景

虽然全身应用利多卡因和镁已被广泛研究作为围手术期镇痛辅助药物,但它们在相同条件下对恢复质量的影响很少被评估。我们比较了接受甲状腺切除术的女性患者静脉注射利多卡因、镁和生理盐水后 QoR-40 评分,以研究它们对麻醉后全面恢复的影响。

方法

在这项前瞻性、双盲试验中,135 名拟行开放性甲状腺切除术的女性患者被随机分为利多卡因组(L 组)、镁组(M 组)或对照组(C 组)。诱导后立即在 L 组给予利多卡因(15 分钟内 2mg/kg,然后 2mg/kg/h),在 M 组给予硫酸镁(15 分钟内 20mg/kg,然后 20mg/kg/h)。C 组给予等量生理盐水。术后第 1 天和第 2 天进行 QoR-40 调查。

结果

L 组术后第 1 天的平均全球 QoR-40 评分为 186.3(标准差 5.5),M 组为 184.3(4.7),C 组为 179.4(17.8),L 组与 C 组之间差异有统计学意义(平均差异 6.9;调整后 P=0.018)。在 QoR-40 的 5 个维度中,L 组的情绪状态、身体舒适度和疼痛均优于 C 组。

结论

与 C 组相比,麻醉期间静脉给予利多卡因可提高术后恢复质量,而镁在本研究中使用的剂量下未能诱导任何显著改善。

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