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腹腔镜胆囊切除术后术中静脉注射利多卡因对术后阿片类药物消耗的影响:一项随机对照试验。

Efficacy of intraoperative intravenous lidocaine infusion on postoperative opioid consumption after laparoscopic cholecystectomy: a randomized controlled trial.

机构信息

Department of Anaesthesiology, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece.

Department of Surgery, General Hospital of Volos, Polymeri 134, 38222, Volos, Greece.

出版信息

Langenbecks Arch Surg. 2023 May 18;408(1):197. doi: 10.1007/s00423-023-02937-x.


DOI:10.1007/s00423-023-02937-x
PMID:37198418
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10191684/
Abstract

PURPOSE: We designed this study to evaluate the impact of intraoperative intravenous lidocaine infusion on postoperative opioid consumption after laparoscopic cholecystectomy. METHODS: In total, 98 patients scheduled for elective laparoscopic cholecystectomy were included and randomized. In the experimental group, intravenous lidocaine (bolus 1.5 mg/kg and continuous infusion 2 mg/kg/h) was administered intraoperatively additionally to the standard analgesia, whereas the control group received a matching placebo. Blinding existed at the level of both the patient and the investigator. RESULTS: Our study failed to confirm any benefit in opioid consumption, during the postoperative period. Lidocaine resulted to reduced intraoperative systolic, diastolic, and mean arterial pressure. Lidocaine administration did not change postoperative pain scores or the incidence of shoulder pain, at any time endpoint. Moreover, we did not identify any difference in terms of postoperative sedation levels and nausea rates. CONCLUSION: Overall, lidocaine did not have any effect on postoperative analgesia after laparoscopic cholecystectomy.

摘要

目的:我们设计本研究旨在评估腹腔镜胆囊切除术患者术中静脉注射利多卡因对术后阿片类药物消耗的影响。

方法:共纳入 98 例行择期腹腔镜胆囊切除术的患者,并进行随机分组。实验组在标准镇痛的基础上额外给予静脉注射利多卡因(负荷量 1.5mg/kg,持续输注 2mg/kg/h),而对照组给予匹配的安慰剂。患者和研究者均设为双盲。

结果:我们的研究未能证实术后阿片类药物消耗有任何获益。利多卡因可降低术中收缩压、舒张压和平均动脉压。利多卡因的应用并未改变任何时间点的术后疼痛评分或肩痛发生率。此外,我们在术后镇静水平和恶心发生率方面也未发现任何差异。

结论:总体而言,利多卡因对腹腔镜胆囊切除术后的镇痛效果没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c1c/10191684/4a2e14856f5a/423_2023_2937_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c1c/10191684/581a561eaf6c/423_2023_2937_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c1c/10191684/823ddfa43d3e/423_2023_2937_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c1c/10191684/4a2e14856f5a/423_2023_2937_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c1c/10191684/581a561eaf6c/423_2023_2937_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c1c/10191684/823ddfa43d3e/423_2023_2937_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c1c/10191684/4a2e14856f5a/423_2023_2937_Fig3_HTML.jpg

相似文献

[1]
Efficacy of intraoperative intravenous lidocaine infusion on postoperative opioid consumption after laparoscopic cholecystectomy: a randomized controlled trial.

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[2]
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[3]
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[4]
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[5]
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[6]
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Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2022-7-13

[7]
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[8]
Pain and Multimodal Analgesia in Laparoscopic Cholecystectomy.

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[9]
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Cochrane Database Syst Rev. 2018-6-4

[10]
[The effect of intraperitoneal administration of dexamethasone on postoperative analgesia after laparoscopic cholecystectomy: a prospective randomized controlled double-blind study].

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引用本文的文献

[1]
A Comparison of Analgesic and Recovery Profiles of Ketamine, Lignocaine, and Dexmedetomidine (KeLiDex) Versus Fentanyl-Based Anesthesia in Laparoscopic Nephrectomies: A Randomized, Single-Blind, Pilot Study.

Cureus. 2024-6-28

[2]
Comparative study of ambulatory versus inpatient laparoscopic cholecystectomy in Thailand: Assessing effectiveness and safety with a propensity score matched analysis.

Ann Hepatobiliary Pancreat Surg. 2024-8-31

[3]
The use of lidocaine infusion in laparoscopic cholecystectomy: An updated systematic review and meta-analysis.

J Minim Access Surg. 2024-7-1

本文引用的文献

[1]
Efficacy of Intravenous Use of Lidocaine in Postoperative Pain Management After Laparoscopic Colorectal Surgery: A Meta-analysis and Meta-regression of RCTs.

In Vivo. 2021

[2]
Learning curve for laparoscopic cholecystectomy has not been defined: A systematic review.

ANZ J Surg. 2021-9

[3]
Comparative outcomes of needlescopic, single-incision laparoscopic, standard laparoscopic, mini-laparotomy, and open cholecystectomy: A systematic review and network meta-analysis of 96 randomized controlled trials with 11,083 patients.

Surgery. 2021-10

[4]
Intravenous Local Anesthetic Compared With Intraperitoneal Local Anesthetic in Laparoscopic Colectomy: A Double-blind Randomized Controlled Trial.

Ann Surg. 2022-1-1

[5]
A randomized clinical trial on the effect of a lidocaine patch on shoulder pain relief in laparoscopic cholecystectomy.

Sci Rep. 2021-1-13

[6]
Intraoperative Hypotension Is Associated With Adverse Clinical Outcomes After Noncardiac Surgery.

Anesth Analg. 2021-6-1

[7]
The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety.

Anaesthesia. 2021-2

[8]
Intravenously injected lidocaine or magnesium improves the quality of early recovery after laparoscopic cholecystectomy: A randomised controlled trial.

Eur J Anaesthesiol. 2021-3-1

[9]
Pharmacological Methods of Postoperative Pain Management After Laparoscopic Cholecystectomy: A Review of Meta-analyses.

Surg Laparosc Endosc Percutan Tech. 2020-12

[10]
Intravenous lidocaine to prevent endothelial dysfunction after major abdominal surgery: a randomized controlled pilot trial.

BMC Anesthesiol. 2020-6-23

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