静脉注射利多卡因或镁可改善腹腔镜胆囊切除术术后早期恢复质量：一项随机对照试验。

Intravenously injected lidocaine or magnesium improves the quality of early recovery after laparoscopic cholecystectomy: A randomised controlled trial.

机构信息

From the The Yancheng Clinical College of Xuzhou Medical University, The First people's Hospital of Yancheng, Yancheng (JL, BQ), The Affiliated Hospital of Xuzhou Medical University (JL, QY, WC), Xuzhou Central Hospital (JFW) and the People's Hospital of Kizilsu Kirghiz Autonomous Prefecture, Xinjiang, PR China (CLG, WC).

出版信息

Eur J Anaesthesiol. 2021 Mar 1;38(Suppl 1):S1-S8. doi: 10.1097/EJA.0000000000001348.

DOI:10.1097/EJA.0000000000001348

PMID:33074940

Abstract

BACKGROUND

Previous data show that lidocaine or magnesium has unique characteristics of stress inhibition and antiinflammation.

OBJECTIVE

We aimed to observe the effects of lidocaine or magnesium on the quality of recovery (QoR) after laparoscopic cholecystectomy.

DESIGN

Single-centre, prospective, randomised, double-blind study.

SETTING

The Affiliated Hospital of Xuzhou Medical University from March 2019 to October 2019.

PATIENTS

One hundred and fourteen patients scheduled for laparoscopic cholecystectomy.

INTERVENTION

The enrolled patients were randomly divided into three groups. Lidocaine (group L), magnesium sulphate (group M) or 0.9% saline (group C) was administered intravenously 10 min before induction.

MAIN OUTCOME MEASURES

The quality of recovery 15 (QoR-15) score, the Hospital Anxiety and Depression Scale (HADS), and the Numerical Rating Scale (NRS) score were selected. The usage of propofol and remifentanil, haemodynamic parameters, anaesthesia recovery parameters and adverse events were also evaluated.

RESULTS

The QoR-15 scores for group L (132.0) and group M (134.0) were 6 and 8 points higher than that of group C (126.0) on POD1 (postoperative day 1) (adjP < 0.05). However, the decrease of QoR-15 in Group L is less than the minimal clinically important difference (8).The NRS scores on POD1 in group C 3, were higher than other two groups (adjP < 0.05). The dosage of remifentanil in group L was lower than other two groups (adjP < 0.05).The physical independence of group L and group M and physical comfort of group M were improved compared with group C.

CONCLUSION

The results show that magnesium sulphate improved the QoR through improving physical comfort and physical independence in patients after laparoscopic cholecystectomy. However, lidocaine had limited effects on QoR under current conditions.

TRIAL REGISTRATION

ChiCTR1800019092 (www.chictr.org.cn).

CLINICAL TRIAL NUMBER AND REGISTRY URL

The study was registered in the Chinese Clinical Trials Register (ChiCTR1800019092) https://www.chictr.org.cn.

摘要

背景

先前的数据表明，利多卡因或镁具有独特的抑制应激和抗炎特性。

目的

观察利多卡因或镁对腹腔镜胆囊切除术后恢复质量（QoR）的影响。

设计

单中心、前瞻性、随机、双盲研究。

地点

徐州医科大学附属医院，2019 年 3 月至 2019 年 10 月。

患者

拟行腹腔镜胆囊切除术的 114 例患者。

干预

纳入的患者被随机分为三组。在诱导前 10 分钟静脉注射利多卡因（L 组）、硫酸镁（M 组）或 0.9%生理盐水（C 组）。

主要观察指标

选择恢复质量 15 分（QoR-15）评分、医院焦虑和抑郁量表（HADS）和数字评分量表（NRS）评分。评估丙泊酚和瑞芬太尼的使用量、血流动力学参数、麻醉恢复参数和不良事件。

结果

L 组（132.0）和 M 组（134.0）在术后第 1 天（POD1）的 QoR-15 评分分别比 C 组（126.0）高 6 分和 8 分（adjP<0.05）。然而，L 组 QoR-15 的下降幅度低于最小临床重要差异（8）。C 组 POD1 的 NRS 评分（3 分）高于其他两组（adjP<0.05）。L 组瑞芬太尼的用量低于其他两组（adjP<0.05）。L 组和 M 组的身体独立性和 M 组的身体舒适度均较 C 组有所改善。