静脉注射利多卡因对促进腹腔镜肾脏手术后恢复的作用:随机对照试验

Dinesh J. Prajapati, Manoj Patel, Pankaj Patel, Arvind Ganpule, Deepak Mistry
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摘要

增强术后恢复(ERAS)已应用于各种腹腔镜手术。作为 ERAS 方案的一部分,静脉注射利多卡因(IVL)被用于腹腔镜手术。该研究旨在评估静脉注射利多卡因在促进腹腔镜肾脏手术后肠道恢复方面的作用。 研究对 80 名在全身麻醉下接受腹腔镜肾脏手术的患者(美国麻醉医师协会体能状态 I-II)进行了随机、双盲、安慰剂对照试验。研究时间为 2018 年 10 月至 2019 年 9 月。通过计算机生成的代码,患者被随机分为两组:L组(利多卡因组)和C组(对照组)。L组在2分钟内静脉注射2%利多卡因(1.5 mg/kg),然后以1.5 mg/kg/h的速度静脉输注利多卡因,直至皮肤闭合。C 组接受相同剂量的注射,然后输注生理盐水。对患者的肠道功能、住院总时间和镇痛剂总用量进行监测。定量数据和事件发生率分别采用学生 t 检验和卡方检验。P<0.05为有统计学意义。 L 组的首次肠鸣音、肠胀气和排便时间分别为(16.4 ± 2.50)、(26.7 ± 9.02)和(39.1 ± 6.31)小时,C 组的首次肠鸣音、肠胀气和排便时间分别为(18.2 ± 2.90)、(32.3 ± 3.11)和(43.3 ± 4.22)小时(P = 0.006、0.001 和 0.01)。L 组和 C 组的总住院时间分别为 4.0 ± 0.74 天和 5.3 ± 0.0.91 天(P < 0.001)。 本研究的结论是,IVL 可促进腹腔镜肾脏手术后的肠道恢复,并缩短总住院时间。
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The role of intravenous lidocaine infusion in enhanced recovery after laparoscopic renal surgeries: A randomized control trial
Enhanced recovery after surgery (ERAS) has been applied in various laparoscopic procedures. Intravenous lidocaine (IVL) infusion is used for laparoscopic procedures as a part of ERAS protocols. The study aimed to evaluate the role of IVL infusion in enhanced bowel recovery after laparoscopic renal surgeries. A randomized, double-blind, placebo-control trial was conducted on 80 patients (with American Society of Anesthesiologists physical status I–II) who presented for laparoscopic renal surgeries under general anesthesia. The study period was from Oct 2018 to Sept 2019. By computer-generated codes, patients were randomly divided into two groups: L (lidocaine) and C (control). Group L received an intravenous (IV) bolus (1.5 mg/kg) of 2% lidocaine over 2 min, followed by an IV lidocaine infusion at the rate of 1.5 mg/kg/h until skin closure. Group C received the same volume of bolus followed by normal saline infusion. Patients were monitored for bowel functions, total hospital stay, and total analgesic consumption. Student’s t-test and Chi-square test were used for quantitative data and occurrence of events, respectively. P <0.05 was considered to be statistically significant. First bowel sound, flatus, and defecation occurred in 16.4 ± 2.50, 26.7 ± 9.02, and 39.1 ± 6.31 h, respectively, in group L and 18.2 ± 2.90, 32.3 ± 3.11, and 43.3 ± 4.22 h, respectively, in group C (P = 0.006, 0.001, and 0.01, respectively). Total hospital stay was 4.0 ± 0.74 and 5.3±0.0.91 days in groups L and C, respectively (P < 0.001). The present study concluded that IVL could enhance the bowel recovery and reduce total hospital stay after laparoscopic renal surgeries.
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