The Study Of Perioperative Intravenous Lidocaine On Postoperative Thoracic Surgery Analgesia

Objective: Perioperative intravenous lidocaine in patients with thoracic surgery, performed after preemptive analgesia and observed postoperative intravenous patient‐controlled analgesia analgesic(PCIA) effect and impact on postoperative rehabilitation.Method:120patients in thoracic surgery under general anesthesia were randomized into2groups with60patients each. Group A：（Lidocaine experimental group）, Medication for the Lidocaine, fentanyl, sufentanil, Dezocine, Ramosetron. Group B：(Control group) Medication for the fentanyl, sufentanil, Dezocine, Ramosetron. All surgical patients and surgical anesthesia is the same. Two groups were given total intravenous anesthesia. Analgesia analgesic method according to each group. Visual analogue score (VAS) was used to evaluate the pain severity. The vital signs and complications were also recorded by an anesthetist who was blind to the groups.Results:1.The VAS score: There were significant difference in VAS score among the two groups (P<0.05). When resting,The VAS scores was lower for the patients with lidocaine in the first，fourth and eighth postoperative hour, which had no significant difference in the24,48，72hours postoperatively. When coughing,the patients in the A‐group showed the better analgesia effects,in the one,four，eight and24hours postoperatively.But no significant difference was observed between patients in A‐group and B‐group in the48and72hours postoperatively.2. The Pressing times of PCIA: The patient of A‐group needed less supplemental use intravenous analgesics than the B‐group, in the one,four，eight and24hours postoperatively.But there were no obvious difference in the other hours.3. The ability of cough and expectoration: when asked to cough and expectorate,patients in A‐group had better obedience than the B‐group.4. No side effect was observed related to lidocaine.5. Ramsay sedation score of two groups of patients, after1h,4h and8h sedation score in group B was significantly lower than that in group A, B sedation in patients less effective. The rest of the time period patients were no significant differences in sedation scores (P>0.05).6. Two groups of patients satisfaction with postoperative analgesia: A group of satisfaction than group B.Conclusion: In the perioperative thoracic surgery, intravenous lidocaine to preemptive analgesia can enhance the analgesic effect of PCIA, effectively relieve postoperative pain, while reducing the incidence of postoperative complications, and no observed serious adverse reactions to lidocaine, can be safely and effectively used in thoracic surgery.