Association between intraoperative intravenous lidocaine infusion and survival in patients undergoing pancreatectomy for pancreatic cancer: a retrospective study

Abstract

Background: Intravenous lidocaine has been shown to reduce opioid consumption and is associated with favourable outcomes after surgery. In this study, we explored whether intraoperative lidocaine reduces intraoperative opioid use and length of stay (LOS) and improves long-term survival after pancreatic cancer surgery. Methods: This retrospective study included 2239 patients who underwent pancreatectomy from January 2014 to December 2017. The patients were divided into non-lidocaine and lidocaine (bolus injection of 1.5 mg kg À1 at the induction of anaesthesia followed by a continuous infusion of 2 mg kg À1 h À1 intraoperatively) groups. The overall use of postoperative rescue analgesia and LOS were recorded. Propensity score matching was used to minimise bias, and disease-free survival and overall survival were compared between the two groups. Results: After propensity score matching, patient characteristics were not significantly different between groups. Intraoperative sufentanil consumption and use of postoperative rescue analgesia in the lidocaine group were significantly lower than those in the non-lidocaine group. The LOS was similar between groups. There was no significant difference in disease-free survival between groups (hazard ratio [HR]¼0.913; 95% confidence interval [CI], 0.821e1.612; P¼0.316). The overall survival rates at 1 and 3 yr were significantly higher in the lidocaine group than in the non-lidocaine group (68.0% vs 62.6%, P<0.001; 34.1% vs 27.2%, P¼0.011). The multivariable analysis indicated that intraoperative lidocaine infusion was associated with a prolonged overall survival (HR¼0.616; 95% CI, 0.290e0.783; P¼0.013). Conclusion: Intraoperative intravenous lidocaine infusion was associated with improved overall survival in patients undergoing pancreatectomy.

Lidocaine Promoted Ferroptosis by Targeting miR-382-5p /SLC7A11 Axis in Ovarian and Breast Cancer

“…An increasing number of evidences have demonstrated that lidocaine could affect the development of multiple tumors including ovarian and breast cancer ( Gao et al, 2018 ; Khan et al, 2019 ; Liu et al, 2021 ). For example, it was reported that intravenous infusion of lidocaine during operation was associated with improved overall survival of patients with pancreatic cancer ( Zhang et al, 2020 ). Gao and colleagues suggested that the administration of lidocaine could enhance the apoptosis of breast cancer cells caused by cisplatin, as well as alleviating their metastasis in vivo ( Gao et al, 2018 ).…”

Potential Impact of Local Anesthetics Inducing Granulocyte Arrest and Altering Immune Functions on Perioperative Outcome

“…The amide type LAs bupivacaine and lidocaine are on the WHO's list of essential drugs 9,10 and may also have antitumor effects for several tumor entities. 11,12 Furthermore, a recent study by Tohme et al observed that neutrophil extracellular traps (NETs), which are chromatin DNA released by PMNs, were implicated in colorectal carcinoma liver metastasis after surgical stress. 13 Galos et al could observe reduced NETosis in women treated with intravenous lidocaine during breast cancer surgery which might result in lower recurrence rates.…”

Scutellarin combined with Lidocaine: a new combination of anti-glioma drugs

“…Epidermal growth factor receptor (EGFR) is a transmembrane glycoprotein and a member of the tyrosine kinase superfamily receptor [20]. Many EGFR gene alterations have been identi ed in gliomas, including ampli cations, deletions and single nucleotide polymorphisms (SNPs) [21][22][23], so it has served as a clinical marker in gliomas [21,23]. More importantly, Lidocaine suppressed the viability, migration, and invasion of lung cancer cells while induced apoptotic death via up-regulation of miR-539, which blocked EGFR signaling by directly binding with EGFR [24].…”