Effects of Systemic Lidocaine on Postoperative Recovery Quality and Immune Function in Patients Undergoing Laparoscopic Radical Gastrectomy

• Main Authors: Lv X (Author), Li X (Author), Guo K (Author), Li T (Author), Yang Y (Author), Lu W (Author), Wang S (Author), Liu S (Author)
• Format: Book
• Published: Dove Medical Press, 2021-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Xueli Lv,1,* Xiaoxiao Li,1,* Kedi Guo,1,* Tong Li,1 Yuping Yang,1 Wensi Lu,1 Shuting Wang,1 Su Liu1,2 1Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People&rsquo;s Republic of China; 2Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People&rsquo;s Republic of China*These authors contributed equally to this workCorrespondence: Su LiuDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People&rsquo;s Republic of ChinaTel [phone]Fax [phone]Email [e-mail]: This study aimed to explore the effects of lidocaine on postoperative quality of recovery (QoR) and immune function in patients undergoing laparoscopic radical gastrectomy.Methods: In total, 135 patients were enrolled and were equally randomized to receive low-dose lidocaine (Group LL: 1.5 mg/kg bolus followed by an infusion at 1.0 mg/kg/hour) or high-dose lidocaine (Group HL: 1.5 mg/kg bolus followed by an infusion at 2.0 mg/kg/hour) or Controls (Group C: received a volume-matched normal saline at the same rate). The primary outcome was a QoR-40 score on postoperative day (POD) 1. Secondary outcomes were a QoR-40 score on POD 3, levels of inflammatory factors (IL-6, IL-10, TNF-&alpha;) and CD4+T cells, CD8+T cells proportions, and CD4+/CD8+ cell ratios and postoperative recovery of bowel function.Results: There were no statistically significant differences in patient characteristics at baseline. The total QoR-40 scores on POD 1 in Group HL (171.4&plusmn; 3.89) were higher than those in Group LL (166.20&plusmn; 4.05) and in Group C (163.40&plusmn; 4.38) (adjusted P< 0.001). Differences in the dimension scores of QoR-40 for pain, physical comfort, and emotional state were significant across the three groups. Lidocaine administration significantly reduced the release of IL-6, IL-10, TNF-&alpha;, and attenuated immune changes induced by trauma. Kaplan&ndash;Meier curves showed that the median time to the first exhaust and defecation were shorter in the Group HL than in Groups LL and C (1.55 days vs 2.4 days vs 2.6 days, log rank P< 0.0001; and 2.86 days vs 3.22 days vs 3.46 days, log rank P=0.002, respectively). Additionally, patients in lidocaine groups required less remifentanil consumption and experienced lower pain intensity, compared with the control group.Conclusion: Systemic lidocaine improved postoperative recovery, alleviated inflammation and immunosuppression, and accelerated the return of bowel function, and is thus, worthy of clinical application.Clinical Trials Registration: ChiCTR2000028934.Keywords: lidocaine, QoR-40, postoperative quality of life, radical gastrectomy

Item Description

1177-8881