Objectives/Hypothesis
Systemic infusions of lidocaine have been widely used as perioperative analgesic adjuvants. The aim of this randomized, double‐blinded, controlled trial was to investigate the effect of perioperative lidocaine infusion on postoperative early recovery quality in upper airway surgery.
Study Design
Prospective, randomized, double‐blinded, placebo‐controlled trial.
Methods
A total of 99 patients were randomly assigned to the lidocaine group (group L) or the control group (group C). The patients received 2 mg/kg lidocaine completed within 10 minutes before the induction of anesthesia followed by continuous infusions of 2 mg/kg/hr lidocaine (group L) or the same volume of 0.9% normal saline (group C) intravenously during anesthesia. The Quality of Recovery‐40 (QoR‐40) survey was administered on the preoperative day (Pre) and postoperative days 1 (POD1) and 2 (POD2). The primary endpoint was QoR‐40 score on POD1 and POD2.
Results
Compared with Pre, global QoR‐40 scores on POD1 and POD2 were significantly lower (P < .05). Compared with group C, global QoR‐40 scores were significantly higher in group L on POD1 and POD2 (P < .05). Among the five dimensions of QoR‐40, the scores for physical comfort, emotional state, and pain were superior in group L compared to group C (P < .05). Compared with group C, the consumption of remifentanil and diclofenac as well as the incidence of postoperative nausea and vomiting (PONV) and postoperative 48‐hour numeric rating scale (NRS) scores in group L were significantly lower (P < .05).
Conclusions
Systemic lidocaine infusion can improve QoR‐40 scores in patients with upper airway surgery, reduce the dosage of intraoperative opioids, decrease the incidence of PONV and NRS scores 2 days after surgery, thus improving postoperative early recovery quality.
Level of Evidence
1b Laryngoscope, 131:E63–E69, 2021