Effect of Systemic Lidocaine on Postoperative Early Recovery Quality in Patients Undergoing Supratentorial Tumor Resection

Abstract

Purpose Lidocaine has been gradually used in general anesthesia. This study was designed to investigate the effect of systemic lidocaine on postoperative quality of recovery (QoR) in patients undergoing supratentorial tumor resection, and to explore its brain-injury alleviation effect in neurosurgical anesthesia. Patients and Methods Sixty adult patients undergoing elective supratentorial tumor resection. Patients were randomly assigned either to receive lidocaine (Group L: 1.5 mg/kg bolus completed 10 min before anesthesia induction followed by an infusion at 2.0 mg/kg/h) or to receive normal saline (Group C: received volume-matched normal saline at the same infusion rate). Primary outcome measures were Quality of Recovery-40 (QoR-40) scores on postoperative day (POD) 1 and 2. Plasma concentrations of S100B protein (S100B), neuron specific enolase (NSE), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) before anesthesia induction and at the end of surgery were assessed. Visual Analogue Scale (VAS) scores were assessed at 1, 2, 6, 12, 24 and 48 h after surgery. Perioperative parameters and adverse events were also recorded. Results Patients between two groups had comparable baseline characteristics. Global QoR-40 scores on POD 1 and POD 2 were significantly higher ( P <0.001) in group L (165.5±3.8 vs 173.7±4.7) than those in group C (155.6±4.0 vs 163.2±4.5); and scores of physical comfort, emotional state, and pain in group L were superior to those in group C ( P <0.05). In group L, patients possessed lower plasma concentration of pro-inflammatory factors (IL-6, TNF-α) and brain injury-related factors (S100B, NSE) ( P <0.05), consumed less remifentanil and propofol, and experienced lower pain intensity. Multiple linear regression analysis demonstrated age and pain were correlated with postperative recovery quality. Conclusion Systemic lidocaine improved early recovery quality after supratentorial tumor resection with general anesthesia, and had certain brain-injury alleviation effects. These benefits may be attributed to the inflammation-alleviating and analgesic properties of lidocaine.

Lidocaine attenuates TMZ resistance and inhibits cell migration by modulating the MET pathway in glioblastoma cells

“…Retrospective studies have shown that lidocaine improves survival in patients with pancreatic ( 49 ) and ovarian cancer ( 50 ). Recent research has revealed that lidocaine can improve the early quality of recovery after brain tumor resection under general anesthesia due to its anti-inflammatory and analgesic properties ( 51 ), suggesting that lidocaine may have the potential to enhance the postoperative outcome of GBM surgery.…”

Effects of perioperative intravenous lidocaine and esketamine on the quality of recovery and emotional state of patients after thyroidectomy: A randomised, double-blind, controlled trial

“…Our results indicate that esketamine and lidocaine infusions during surgery have a significant positive effect on improving the quality of recovery for patients. Similarly, in experiments on supratentorial tumour resection,[ 15 ] upper airway surgery[ 16 ] and video-assisted thoracic surgery,[ 17 ] the administration of lidocaine or esketamine through IV infusion during the perioperative period demonstrated a notable enhancement in the postoperative recovery outcomes. However, some reports have come to different conclusions.…”

Inhibitory Actions of Clinical Analgesics, Analgesic Adjuvants, and Plant-Derived Analgesics on Nerve Action Potential Conduction

“…The peak amplitudes of sodium channels resistant to TTX in rats were concentration-dependently reduced by lidocaine; an IC 50 value for this activity was 0.073 mM [145], which was 10 times less than that for the reduction of frog sciatic nerve CAP peak amplitudes. At least part of antinociception produced by systemically applied lidocaine in humans [146] may be attributed to its inhibitory effect on nerve AP conduction.…”