Yang Dawei, Yang Qian, Wang Yixing, Liu Fengxia, Xing Zhi, Li Shitong, Zhang Jianyou
Department of Anesthesiology, Affiliated Hospital of Yangzhou University, China.
Department of Anesthesiology, First People's Hospital Affiliated to Shanghai Jiaotong University, China.
Adv Clin Exp Med. 2025 Jul;34(7):1139-1144. doi: 10.17219/acem/192879.
Intravenous infusion of lidocaine as an anesthesia adjuvant can improve patient outcomes, but its impact on intrapulmonary shunt during one-lung ventilation (OLV) has not been clarified.
To determine the effect of intravenous lidocaine infusion on intrapulmonary shunt during OLV and postoperative cognitive function in video-assisted thoracoscopic surgery (VATS).
Sixty patients who underwent OLV for thoracic surgery were randomized to receive intravenous infusion of lidocaine (lidocaine group, n = 30) or normal saline (control group, n = 30) for anesthesia induction. Arterial and venous blood gases were measured during two-lung ventilation and at 15 and 30 min after OLV (OLV + 15 and OLV + 30). The Mini-Mental State Examination was administered before the surgery and at postoperative 12 months to assess patient cognitive function.
No significant difference was found in intrapulmonary shunt fraction (Qs/Qt) between the lidocaine group and the control group at OLV + 15 (p = 0.493) and OLV + 30 (p = 0.754). The lidocaine group used significantly lower doses of propofol and remifentanil compared to the control group (both p < 0.001). Furthermore, no significant difference was observed in the incidence of postoperative cognitive dysfunction between the lidocaine group and the control group at 1 year post-operation (3.3% vs 6.7%, p = 0.554).
Intravenous lidocaine administered in VATS had no significant impact on intrapulmonary shunt during OLV or postoperative cognitive function. However, it significantly reduced the doses of anesthetics used during the surgery.
静脉输注利多卡因作为麻醉辅助剂可改善患者预后，但其对单肺通气（OLV）期间肺内分流的影响尚未明确。
确定静脉输注利多卡因对OLV期间肺内分流以及电视辅助胸腔镜手术（VATS）术后认知功能的影响。
60例行胸外科OLV的患者被随机分为两组，麻醉诱导时分别接受静脉输注利多卡因（利多卡因组，n = 30）或生理盐水（对照组，n = 30）。在双肺通气期间以及OLV后15分钟和30分钟（OLV + 15和OLV + 30）测量动脉和静脉血气。术前及术后12个月进行简易精神状态检查以评估患者认知功能。
利多卡因组与对照组在OLV + 15（p = 0.493）和OLV + 30（p = 0.754）时的肺内分流分数（Qs/Qt）无显著差异。与对照组相比，利多卡因组丙泊酚和瑞芬太尼的使用剂量显著更低（均p < 0.001）。此外，术后1年利多卡因组与对照组术后认知功能障碍的发生率无显著差异（3.3%对6.7%，p = 0.554）。
VATS中静脉输注利多卡因对OLV期间的肺内分流或术后认知功能无显著影响。然而，它显著降低了手术期间使用的麻醉剂剂量。
