【Classic literature reading】The effect of lidocaine infusion in thoracoscopic radical total pneumonectomy on chronic pain in patients after surgery

Effect of lidocaine perioperative infusion on chronic postsurgical pain in patients undergoing thoracoscopic radical pneumonectomy

Effect of lidocaine infusion in thoracoscopic radical total pneumonectomy on chronic pain in patients after surgery

by Dani & Miao & Cat

Background: Thoracoscopic radical total pneumonectomy is associated
with a high incidence of chronic pain after surgery.
However, the benefits of intravenous lidocaine infusion during thoracoscopic surgery remain controversial
.

Methods: Sixty-four patients with lung cancer were randomly divided into normal saline group (control group) and lidocaine group
.
Lidocaine was given 1.
5 mg/kg during anesthesia induction in the lidocaine group, and 2 mg·kg−1·h−1 lidocaine was continued intravenously until the end of
surgery.
Postoperative patient analgesic pump (formula: 2 μg/kg sufentanil + 10 mg/kg lidocaine for 100ml) continued intravenous infusion
.
The control group was given the same amount of normal saline
for the calculation of lidocaine in anesthesia induction, maintenance, and postoperative self-control analgesia.
Key results: incidence of
chronic pain within 3 months postoperatively.
Secondary outcomes: incidence of chronic pain at 6 months postoperatively, acute pain at 24 and 48 hours postoperatively, total amount of sufentanil, number of
PCA triggers in 48 hours postoperatively.

Results: The incidence of chronic pain in the lidocaine group was significantly reduced within 3 months after surgery (46.
4% vs 20.
7%, p<0.
05).

However, there was no significant difference
between the two groups at within 6.
The total amount of sufentanil in the perioperative period was significantly lower in the lidocaine group (149.
64±18.
20 μg vs139.
47±16.
75 μg) (p<0.
05) but the number of triggers was more frequent (8.
21±4.
37 vs.
5.
83±4.
12, p<0.
05) There was no difference between
the 24h and 48hNRS scores in the two groups.
(1.
68±0.
72 vs.
1.
90±0.
86) (1.
21±0.
42 vs.
1.
20±0.
41)

Figure&Table

flow chart

Baseline characteristics

Occurrence and characteristics of chronic pain within 3 months after surgery

Occurrence and characteristics of chronic pain within 6 months after surgery

Intraoperative drug dosage comparison

Original link

https://doi.
org/10.
1186/s12871-022-01795-2