Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Ambulatory Surgery Center, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
BJS Open. 2023 Mar 7;7(2). doi: 10.1093/bjsopen/zrad014.
This prospective study investigated whether a single dose of intravenous lidocaine could alleviate tourniquet hypertension in patients undergoing ambulatory arthroscopy under general anaesthesia.
Patients aged 18-65 years undergoing knee arthroscopy under general anaesthesia were randomly divided into the lidocaine group (L group) and the normal saline group (N group). Patients received an intravenous injection 10 min before tourniquet inflation of either 1.5mg/kg lignocaine made up to 10ml with 0.9 per cent normal saline, or 10ml of 0.9 per cent normal saline. The primary outcome was the incidence of tourniquet hypertension. Secondary outcomes included haemodynamic changes, degree of elevation of blood pressure, changes in serum inflammatory indicators including interleukin 6 and tumour necrosis factor-α, the numerical rating scale, 15-item quality of recovery after surgery, the incidence of adverse events and the duration of hospital stay. Randomization was computer-generated with allocation concealment by sealed envelopes. Patients, caregivers and researchers were all blind to the allocation group throughout the study.
Ninety-six patients were included in the study; 48 in each group. Compared with the N group, the incidence of tourniquet hypertension in the L group was significantly lower (37.5 per cent versus 68.8 per cent; P < 0.002). The degree of elevation of systolic blood pressure from baseline to the end of surgery in the L group was significantly lower than the N group (17.1 per cent versus 23.6 per cent; P = 0.020). The concentration of tumour necrosis factor-α in the L group 5 min after tourniquet deflation was lower than in the N group (32.12 pg/ml versus 39.89 pg/ml; P = 0.029). The median numerical rating scale of the L group was significantly lower at 6 h (0 versus 3.0; P = 0.003) and 24 h (0 versus 2.0; P < 0.001) after surgery. In the L group, the total 15-item quality of recovery was significantly increased (131 versus 128; P = 0.017).
Single injection of intravenous lidocaine alleviated tourniquet hypertension in ambulatory arthroscopic patients under general anaesthesia. Intravenous lidocaine can inhibit tourniquet hypertension formation by reducing tumour necrosis factor-α release, and has beneficial effects on postoperative pain and recovery.
ChiCTR2200055551 (http://www.chictr.org.cn/edit.aspx? pid=148235&htm=4).
本前瞻性研究旨在探讨单次静脉注射利多卡因是否能缓解全身麻醉下接受日间关节镜检查患者的止血带高血压。
选择年龄在 18-65 岁之间、全身麻醉下接受膝关节镜检查的患者，随机分为利多卡因组（L 组）和生理盐水组（N 组）。在止血带充气前 10 分钟，患者分别接受 1.5mg/kg 利多卡因 10ml 加 0.9%生理盐水或 10ml 0.9%生理盐水静脉注射。主要结局是止血带高血压的发生率。次要结局包括血流动力学变化、血压升高程度、血清炎症指标白细胞介素 6 和肿瘤坏死因子-α的变化、数字评分量表、术后 15 项恢复质量、不良事件发生率和住院时间。随机化采用计算机生成，密封信封进行分配隐藏。在整个研究过程中，患者、护理人员和研究人员均对分组情况不知情。
本研究共纳入 96 例患者，每组 48 例。与 N 组相比，L 组止血带高血压的发生率明显较低（37.5%比 68.8%；P<0.002）。L 组从基线到手术结束时收缩压的升高幅度明显低于 N 组（17.1%比 23.6%；P=0.020）。L 组止血带放气后 5 分钟肿瘤坏死因子-α的浓度低于 N 组（32.12pg/ml 比 39.89pg/ml；P=0.029）。L 组术后 6 小时（0 比 3.0；P=0.003）和 24 小时（0 比 2.0；P<0.001）的数字评分量表中位数明显较低。L 组的 15 项总恢复质量明显增加（131 比 128；P=0.017）。
单次静脉注射利多卡因可缓解全身麻醉下日间关节镜手术患者的止血带高血压。静脉注射利多卡因可通过减少肿瘤坏死因子-α的释放来抑制止血带高血压的形成，对术后疼痛和恢复有有益影响。
ChiCTR2200055551（http://www.chictr.org.cn/edit.aspx?pid=148235&htm=4）。
