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局部浸润利多卡因能否降低肺癌行肺叶切除术患者的术后心房颤动发生率?

Can local infiltration of lidocaine reduce the postoperative atrial fibrillation rate in patients undergoing lobectomy for lung cancer?

机构信息

Department of Thoracic Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

Acta Chir Belg. 2020 Aug;120(4):265-270. doi: 10.1080/00015458.2019.1610259. Epub 2019 May 6.

DOI:10.1080/00015458.2019.1610259
PMID:31010387
Abstract

Postoperative atrial fibrillation (POAF) occurs frequently after lung cancer surgery. Unfortunately, owing to the multifactorial etiology of POAF, no single drug or intervention can prevent POAF in all cases. The effects of local interventions after lung cancer surgery are unknown. This study investigated the effects of local infiltration of an anesthetic (lidocaine) on the post-lobectomy POAF rate. This non-randomized study included 81 patients who underwent lobectomy for lung cancer. Patients were divided into a lidocaine-infiltration group comprising patients who received lidocaine infiltration around the pulmonary veins and a no-intervention group. Patients were monitored for the development of POAF during hospitalization. Pre- and postoperative demographic and clinical data were analyzed. AF occurred in 3 (7.5%) of 40 patients in the lidocaine-infiltration group and in 10 (24.39%) of 41 patients in the standard surgical resection group. Overall, it was observed that intraoperative lidocaine infiltration resulted in a lower POAF rate ( < .05). Local infiltration of lidocaine around the pulmonary veins in patients undergoing lobectomy for lung cancer was associated with a lower incidence of POAF, which is attributable to the local anesthetic and autonomic effects of lidocaine.

摘要

术后心房颤动(POAF)在肺癌手术后经常发生。不幸的是,由于 POAF 的多因素病因,没有一种药物或干预措施可以预防所有情况下的 POAF。局部干预措施对肺癌手术后 POAF 的影响尚不清楚。本研究调查了局部浸润麻醉(利多卡因)对肺叶切除术后 POAF 发生率的影响。这项非随机研究纳入了 81 例因肺癌行肺叶切除术的患者。患者分为利多卡因浸润组(接受肺静脉周围利多卡因浸润的患者)和无干预组。患者在住院期间监测 POAF 的发生情况。分析了术前和术后的人口统计学和临床数据。利多卡因浸润组 40 例患者中有 3 例(7.5%)发生 AF,标准手术切除组 41 例患者中有 10 例(24.39%)发生 AF。总体而言,术中利多卡因浸润可降低 POAF 发生率( < .05)。在接受肺癌肺叶切除术的患者中,肺静脉周围局部浸润利多卡因与 POAF 发生率降低相关,这归因于利多卡因的局部麻醉和自主神经作用。

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CJC Open. 2025 Jan 28;7(5):579-587. doi: 10.1016/j.cjco.2025.01.018. eCollection 2025 May.
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The Use of Intravenous Lidocaine in Perioperative Medicine: Anaesthetic, Analgesic and Immune-Modulatory Aspects.静脉注射利多卡因在围手术期医学中的应用:麻醉、镇痛及免疫调节方面
J Clin Med. 2022 Jun 20;11(12):3543. doi: 10.3390/jcm11123543.
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Lidocaine inhibited migration of NSCLCA549 cells via the CXCR4 regulation.
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Front Cell Dev Biol. 2020 Jul 17;8:565. doi: 10.3389/fcell.2020.00565. eCollection 2020.