Surgery Clinical Trial
Official title:
The Study of Perioperative Intravenous Infusion of Lidocaine on Postoperative Analgesia in Patients Undergoing Single-port Thoracoscopic
The purpose of this study is to evaluate the effect of intravenous lidocaine infusion on pain and opioid dosage in patients undergoing single-port thoracoscopic surgery,and to evaluate the effects of perioperative catecholamine levels, extubation time, incidence of nausea and vomiting, patient satisfaction and hospital stay.
The World Congress on Pain identified pain as the "fifth leading indicator of human life"
after breathing, pulse, body temperature and blood pressure. Postoperative pain is an acute
nociceptive pain caused by surgical trauma and is a complex stress response in the body,
especially in 72 hours after surgery. Pain after thoracic surgery is a more severe type of
surgery in various types of surgery.
Acute pain at the early stage of operation is not only an external signal of body injury, but
also an independent factor inducing stress response and systemic inflammatory response
syndrome (SIRS). Pain stimulus can also cause excessive release of catecholamine, damage of
vascular endothelial cells and neutrophil aggregation, which can induce cytokine "waterfall"
secretion. Stress, pain and inflammation induce and interact with each other, which seriously
affects the early recovery of patients after operation. Timely and effective post-operative
analgesia can not only alleviate patients'pain, but also avoid a series of stress reactions.
It provides favorable conditions for the stability of patients' physiological function and
recovery of their body after operation.
Although multimodal analgesia has largely replaced monotherapy with opioids, they are still
the most commonly used drugs for postoperative pain. Lidocaine is an amide local anesthetic
which when used intravenously demonstrates significant analgesic, anti-hyperalgesic and
anti-inflammatory properties .
Intravenous infusion of lidocaine has a good effect on fibromyalgia, chronic neuropathic
pain, opioid tolerance and other chronic pain, and can reduce postoperative acute pain. In
the 1960s, Barlett et al. first published a study on the use of lidocaine intravenous
infusion for postoperative analgesia.Since then, more and more researchers have begun to
explore the use of lidocaine in the treatment of postoperative acute pain.In 2007, Kaba et
al. selected patients who underwent colectomy as an experimental subject, and intravenously
injected lidocaine during the perioperative period. The results showed that the pain of the
experimental group was effectively relieved and the use of opioids was reduced. In 2008,
Lauwick et al. used laparoscopic cholecystectomy as the experimental subject. The results
showed that the dose of opioid analgesia in the lidocaine group was significantly lower than
that in the control group, and the postoperative pain was effectively improved. In 2009,
Yardeni et al. selected patients undergoing total hysterectomy as experimental subjects and
intravenously injected lidocaine during the perioperative period. The results confirmed that
the hemodynamics of the experimental group was more stable, the average dosage of anesthetics
was reduced, and the pain was significantly improved.However, to date, there is no strong
evidence for the effect of perioperative intravenous infusion of lidocaine in single-port
thoracoscopic surgery, so we designed this study.
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