Yang Hui, Wang Luyao, Zhu Kairun, Shen Lulu, Wang Lei, Huai De, Xie Chenglan
Department of Anesthesiology, The Affiliated Huaian Hospital of Xuzhou Medical University and Huaian Second People's Hospital, 62 South Huaihai Road, Huaian, 223002, China.
Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Huaian Hospital of Xuzhou Medical University and Huaian Second People's Hospital, 62 South Huaihai Road, Huai'an, China.
Eur Arch Otorhinolaryngol. 2025 Feb;282(2):797-805. doi: 10.1007/s00405-024-09045-6. Epub 2024 Nov 4.
Perioperative intravenous lidocaine infusion can improve the quality of recovery (QoR) in patients undergoing functional endoscopic sinus surgery (FESS), but the effect of esmolol on recovery has been rarely studied. The aim of this study to compare the effects of esmolol and lidocaine on the QoR in patients with FESS.
A total of 60 patients were randomly divided into Group E: intravenous esmolol (0.5 mg/kg for 1 min, followed by 3.0 mg/kg/h); Group L: intravenous lidocaine (2.0 mg/ kg for 10 min, followed by 2 mg/kg/h). The quality of recovery-15 (QoR-15) score was compared. Other parameters compared were the numeric rating pain scale (NRS), haemodynamic data, Surgical field conditions, intraoperative drug dosages, number of cases of remedial analgesia, time to awakening and incidence of postoperative sore throat (POST) as well as postoperative nausea and vomiting (PONV).
The mean difference in the QoR-15 score between Group E and Group L on postoperative day 1 (POD1) was - 1.37 (95% CI - 2.75 to 0.01; P < 0.001 for noninferiority), indicating the noninferiority of esmolol. Haemodynamic changes and intraoperative nitroglycerine dosages were significantly lower in Group E than in Group L (P < 0.05). The scores of surgical field quality (SSFQ) was higher in Group E than in Group L (P < 0.05).
Intravenous infusion of esmolol is not inferior to lidocaine in the quality of postoperative recovery in patients with FESS, and is more advantageous in terms of the quality of the surgical field, attenuation of intraoperative haemodynamic fluctuations, and postoperative awakening.
围手术期静脉输注利多卡因可改善功能性鼻内镜鼻窦手术（FESS）患者的恢复质量（QoR），但艾司洛尔对恢复的影响鲜有研究。本研究旨在比较艾司洛尔和利多卡因对FESS患者QoR的影响。
总共60例患者被随机分为E组：静脉注射艾司洛尔（0.5mg/kg，持续1分钟，随后3.0mg/kg/h）；L组：静脉注射利多卡因（2.0mg/kg，持续10分钟，随后2mg/kg/h）。比较恢复质量-15（QoR-15）评分。还比较了其他参数，包括数字疼痛评分量表（NRS）、血流动力学数据、手术视野情况、术中药物剂量、补救性镇痛病例数、苏醒时间以及术后咽痛（POST）和术后恶心呕吐（PONV）的发生率。
术后第1天（POD1）E组和L组QoR-15评分的平均差异为-1.37（95%CI -2.75至0.01；非劣效性检验P<0.001），表明艾司洛尔不劣于利多卡因。E组的血流动力学变化和术中硝酸甘油剂量显著低于L组（P<0.05）。E组的手术视野质量评分（SSFQ）高于L组（P<0.05）。
静脉输注艾司洛尔在FESS患者术后恢复质量方面不劣于利多卡因，且在手术视野质量、术中血流动力学波动的衰减以及术后苏醒方面更具优势。
