Pulmanary Protection Of Lidocaine On Patients Undergoing Laparoscopic Rectal Cancer Surgery: A Clinical Research

Objectives:To evaluate the protective effects of lidocaine on the lungs in patients undergoing laparoscopic rectal cancer surgery.Methods:80 patients with American Society of Anesthesiologist physical status Ⅰor Ⅱ,were selected for laparoscopic radical resection of rectal cancer under intravenous general anesthesia.The patients were randomly divided into two groups(n=40): lidocaine group(group L)and control group(group C).10 minutes before induction of anesthesia,2% lidocaine was injected intravenously in a loading dose of 1.5mg·kg-1,and then infused intravenously at the rate of 1.5mg·kg-1·h-1 in group L continuously until the end of the operation,while the equal volume of normal saline was given at the same time point in group C.After induction of anesthesia,CO2 pneumoperitoneum was established,and the pressure was set to 12-15 mm Hg.Some critical time points are as follows: Before pneumoperitoneum(T0),at 30,60 and 120 minutes of pneumoperitoneum(T1-3),and at 30 minutes after deflation(T4),At these time points,peripheral venous blood samples were taken for determination of serum interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),malondialdehyde(MDA)and Clara cell 16-k Da secretory protein(CCl6)concentrations by enzyme-linked immunosorbent assay.At the same time,the HR,MAP,PETCO2 and Ppeak were recorded,arterial blood gas analysis was performed,and oxygenation index(OI)and respiratory index(RI)were calculated.Results:1.There was no significant difference in general and surgical conditions between the two groups(P>0.05).2.Compared with the baselines at T0,the HR and MAP significantly increased at T1-4(P<0.05);There was no significant difference in the HR and MAP between the two groups(P>0.05).3.Compared with the baselines at T0,the PETCO2 and Ppeak significantly increased at T1-4(P<0.05);Compared with that in group C,the Ppeak significantly decreased at T3,T4 in group L(P<0.05).4.Compared with the baselines at T0,the serum IL-6,TNF-α,MDA and CCl6 concentrations significantly increased at T2-4 in group C.The serum IL-6 and TNF-α concentrations at T2-4,serum MDA concentrations at T4 and serum CCl6 concentrations at T3,T4 significantly increased in group L(P<0.05).Compared with concentrations in group C,the serum IL-6 and TNF-α concentrations at T2-4 and the serum MDA and CCl6 concentrations at T3,T4 significantly decreased in group L(P<0.05).5.Compared with the baselines at T0,the OI increased and RI decreased in T1-4 in both groups(P<0.05).Compared with those in group C,the OI increased and RI decreased at T3,T4 in group L(P<0.05).Conclusions:Lidocaine can alleviate inflammatory response and oxidative stress,mitigate the degree of lung injury,and improve pulmonary ventilation function.Therefore,it certainly has a protective effect on the lungs of the patients undergoing laparoscopic radical rectal cancer surgery.