Impact of lidocaine on hemodynamic and respiratory parameters during laparoscopic appendectomy in children

Kaszyński, M; Stankiewicz, B.; Pałko, Krzysztof Jakub; Darowski, M.; Pągowska‐Klimek, Izabela

doi:10.1038/s41598-022-18243-3

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…The results showed that the RG had evidently shorter time to loss of eyelash reflex, pain resolution, and recovery from anesthesia than the CG, suggesting that ATR + REMI can establish a good anesthetic effect in pediatric AA surgery. The major AEs observed after AA surgery in children were respiratory depression, hypoxemia, bradycardia, nausea and vomiting, and hypotension, similar to the results reported by Kaszyński et al [ 20 ]. RG had a lower overall incidence of AEs than CG, indicating the increased benefit conferred by ATR + REMI, thereby preventing postoperative AEs in pediatric patients undergoing surgery for AA.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of the clinical effects of atropine in combination with remifentanil in children undergoing surgery for acute appendicitis

Li,

Chen,

Lin

et al. 2024

World J Gastrointest Surg

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BACKGROUND Acute appendicitis (AA) is the most common cause of acute abdomen in children. Anesthesia significantly influences the surgical treatment of AA in children, making the scientific and effective selection of anesthetics crucial. AIM To assess the clinical effect of atropine (ATR) in combination with remifentanil (REMI) in children undergoing surgery for AA. METHODS In total, 108 cases of pediatric AA treated between May 2020 and May 2023 were selected, 58 of which received ATR + REMI [research group (RG)] and 50 who received REMI [control group (CG)]. Comparative analyses were conducted on the time to loss of eyelash reflex, pain resolution time, recovery time from anesthesia, incidence of adverse events (AEs; respiratory depression, hypoxemia, bradycardia, nausea and vomiting, and hypotension), intraoperative responses (head shaking, limb activity, orientation recovery, safe departure time from the operating room), hemodynamic parameters [oxygen saturation (SPO2), mean arterial pressure, heart rate, and respiratory rate], postoperative sedation score (Ramsay score), and pain level [the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale]. RESULTS Compared with the CG, the RG showed significantly shorter time to loss of eyelash reflex, pain resolution, recovery from anesthesia, and safe departure from the operating room. Furthermore, the incidence rates of overall AEs (head shaking, limb activity, etc. ) were lower, and influences on intraoperative hemodynamic parameters and stress response indexes were fewer. The Ramsay score at 30 min after extubation and the FLACC score at 60 min after extubation were significantly lower in the RG than in the CG. CONCLUSION ATR + REMI is superior to REMI alone in children undergoing AA surgery, with a lower incidence of AEs, fewer influences on hemodynamics and stress responses, and better post-anesthesia recovery.

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Section: Discussionsupporting

confidence: 87%

Evaluation of the clinical effects of atropine in combination with remifentanil in children undergoing surgery for acute appendicitis

Li,

Chen,

Lin

et al. 2024

World J Gastrointest Surg

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“…Depue et al showed that the combined treatment of 0.25 to 0.5 mg/kg of preoperative IV lidocaine with propofol infusion did not significantly affect the pain and distress of 2 - 7 years old patients and the distress of their parents and physicians during the procedure ( 42 ). In another study of children aged 3 - 17, lidocaine infusion during laparoscopic appendectomy did not improve circulatory and respiratory alterations during pneumoperitoneum ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

“…Forster et al evaluated 40 adults and showed that IV lidocaine in combination with ketamine and propofol for colonoscopy reduced the required doses of propofol ( 34 ). Although preoperative administration of lidocaine is currently recommended in adult patients, the current recommendations regarding the use of this drug in children are still contradictory ( 35 ). In this study, we investigated the effect of adding IV lidocaine to ketamine on the hemodynamic status, endoscopist satisfaction, and patient recovery time in pediatric patients undergoing GI endoscopy.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Preoperative Combined with Intravenous Lidocaine and Ketamine vs. Intravenous Ketamine on Pediatric Patients Undergoing Upper Gastrointestinal Endoscopy

et al. 2023

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Background: Ketamine is widely used in pediatric sedation. New studies have recommended combination therapy to reduce the side effects of ketamine. Objectives: This study investigated the effect of adding intravenous (IV) lidocaine to ketamine on hemodynamic parameters, endoscopist satisfaction, and recovery time of children undergoing gastrointestinal endoscopy. Methods: This triple-blind, randomized, controlled clinical trial was conducted in Isfahan, Iran (2021). One hundred twenty children between the ages of 1 and 6 were enrolled. Patients were divided into 2 groups. The intervention group received 1.0 mg/kg of IV lidocaine and 1.0 mg/kg of IV ketamine, and the placebo group received 1.0 mg/kg of IV ketamine and placebo 2 minutes before entering the endoscopic room. Patients in both groups were sedated with 1.0 mg/kg of propofol, 0.1 mg/kg of midazolam, and 2.0 ug/kg of fentanyl for the procedure. The pulse rate, mean arterial pressure (MAP), respiratory rate, and oxygen saturation were recorded 1 minute before injection and every 5 minutes afterward. Results: The mean (SD) ages of the intervention and control groups were 3.4 (1.5) and 3.4 (1.7), respectively. The mean difference in hemodynamic parameters between the 2 groups was insignificant during the investigation (P > 0.05). Furthermore, no significant differences were found regarding endoscopist satisfaction scores and length of recovery room stay (P > 0.05). Conclusions: Adding low-dose IV lidocaine to ketamine for pediatric sedation does not significantly affect the hemodynamic status, endoscopist satisfaction, and recovery time.

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“…However, some studies in recent years have shown that with an appropriate dose and infusion speed, lidocaine intravenous injection will not cause serious local anesthetic toxicity. 15–17 In the present study, we chose continuous intravenous lidocaine to explore whether systemic lidocaine can reduce the incidence of POD in elderly patients. The loading dose and continuous infusion dose were determined with reference to the international consensus statement.…”

Section: Discussionmentioning

confidence: 99%

Effect of Intraoperative Intravenous Lidocaine on Postoperative Delirium in Elderly Patients with Hip Fracture: A Prospective Randomized Controlled Trial

Li,

Wu,

Lan

et al. 2023

DDDT

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Purpose This study was performed to evaluate the effects of intraoperative intravenous lidocaine on postoperative delirium in elderly patients with hip fracture. Patients and methods In total, 100 elderly patients undergoing hip fracture surgery were randomized to the lidocaine group (Group L) or saline (control) group (Group C). Before anesthetic induction, Group L received lidocaine at 1 mg/kg for more than 10 minutes followed by continuous infusion at 1.5 mg/kg/h until the end of surgery. Group C received normal saline, and the injection methods were consistent with those in Group L. General anesthesia was induced with propofol, sufentanil, and cis-atracurium. Anesthesia was maintained by propofol and remifentanil. The primary outcome was the incidence of postoperative delirium in the first 7 postoperative days. The secondary outcomes included the severity of delirium, onset and duration of delirium, emergence agitation, adverse events, total propofol dose, intraoperative opioid dosage, length of post-anesthesia care unit stay, extubation time, and patient satisfaction with postoperative pain management. Results All 100 patients completed the study. The incidence of postoperative delirium was lower in Group L than in Group C (14% vs 36%, P = 0.011). The delirium severity scores were lower in Group L (3 [3–4]) than in Group C (4 [4–5]) ( P = 0.017). In addition, the incidences of hypertension, tachycardia, and emergence agitation were significantly lower in Group L than in Group C. No cases of local anesthetic toxicity occurred in either group. Conclusion Patients received lidocaine at 1 mg/kg for more than 10 minutes followed by continuous infusion at 1.5 mg/kg/h until the end of surgery, which can reduce the incidence of postoperative delirium in elderly patients undergoing hip fracture. In addition, the used regimen of lidocaine would not increase the risk of local anesthetic toxicity.

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Impact of lidocaine on hemodynamic and respiratory parameters during laparoscopic appendectomy in children

Cited by 3 publications

References 19 publications

Evaluation of the clinical effects of atropine in combination with remifentanil in children undergoing surgery for acute appendicitis

Evaluation of the clinical effects of atropine in combination with remifentanil in children undergoing surgery for acute appendicitis

The Effect of Preoperative Combined with Intravenous Lidocaine and Ketamine vs. Intravenous Ketamine on Pediatric Patients Undergoing Upper Gastrointestinal Endoscopy

Effect of Intraoperative Intravenous Lidocaine on Postoperative Delirium in Elderly Patients with Hip Fracture: A Prospective Randomized Controlled Trial

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