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Effects of Systemic Lidocaine Versus Dexmedetomidine on the Recovery Quality and Analgesia After Thyroid Cancer Surgery: A Randomized Controlled Trial

INTRODUCTION: Surgical management is commonly used for thyroid cancer. We evaluated the effects of systemic lidocaine versus dexmedetomidine on the recovery quality and analgesia after thyroid cancer surgery. METHODS: A total of 120 patients with thyroid cancer were randomly allocated to group L (re...

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Autores principales: Shu, Teng, Xu, Siqi, Ju, Xia, Hu, Shenghong, Wang, Shengbin, Ma, Li
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633913/
https://www.ncbi.nlm.nih.gov/pubmed/36203077
http://dx.doi.org/10.1007/s40122-022-00442-5
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author Shu, Teng
Xu, Siqi
Ju, Xia
Hu, Shenghong
Wang, Shengbin
Ma, Li
author_facet Shu, Teng
Xu, Siqi
Ju, Xia
Hu, Shenghong
Wang, Shengbin
Ma, Li
author_sort Shu, Teng
collection PubMed
description INTRODUCTION: Surgical management is commonly used for thyroid cancer. We evaluated the effects of systemic lidocaine versus dexmedetomidine on the recovery quality and analgesia after thyroid cancer surgery. METHODS: A total of 120 patients with thyroid cancer were randomly allocated to group L (received lidocaine 1.5 mg/kg loading, continuously infused 1.5 mg/kg per hour), group D (received dexmedetomidine 0.5 µg/kg loading, continuously infused 0.5 µg/kg per hour) and group C (received normal saline), with 40 cases in each group. Anaesthesia induction and maintenance were performed using target-controlled infusions (TCIs) of propofol and remifentanil. The primary outcome of the quality of recovery-15 (QoR-15) score was recorded on the day before surgery and postoperative day 1 (POD1). Secondary outcomes included the consumption of remifentanil during surgery, time to first required rescue analgesia, number of patients requiring rescue analgesia, postoperative cumulative consumption of tramadol, visual analogue scale (VAS) pain score, incidence of postoperative nausea or vomiting (PONV) and side effects. RESULTS: The total score of the QoR-15 at POD1 (median, IQR) was higher in group L (128.0, 122.0–132.8) and group D (127.5, 122.5–132.5) compared to group C (118.5, 113.0–123.5) (P = 0.000). Compared to group C, systemic lidocaine and dexmedetomidine reduced cumulative consumption of remifentanil and VAS pain score (P = 0.000). The time to first required rescue analgesia (mean, SD) was longer in group L (8.1 h, 1.2 h) and group D (8.5 h, 1.9 h) than group C (5.9 h, 0.9 h) (P = 0.000). The number of patients requiring rescue analgesia was lower in group L (8/40, 20%) and group D (6/40, 15%) than group C (16/40, 40%) (P = 0.029), and cumulative consumption of tramadol (mean, SD) was lower in group L (44.0 mg, 17.1 mg) and group D (51.7 mg, 14.1 mg) than group C (73.9 mg, 18.4 mg) (P = 0.000). The incidence of PONV in group L (7/40, 17.5%) and group D (9/40, 22.5%) was lower than group C (18/40, 45.0%) (P = 0.016). Bradycardia (heart rate  less than 50 beats/min or lower) was noted in 25 patients (25/40, 62.5%), which was reversed by intravenous administration of atropine 0.5 mg. CONCLUSION: Systemic lidocaine and dexmedetomidine had similar effects on enhancing the quality of recovery, alleviating the intensity of pain and reducing the incidence of PONV after thyroid cancer surgery. However, dexmedetomidine may result in bradycardia. Therefore, lidocaine was superior to dexmedetomidine. TRIAL REGISTRATION: ChiCTR.org.cn (ChiCTR2000038442). Registered on September 22, 2020.
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spelling pubmed-96339132022-12-07 Effects of Systemic Lidocaine Versus Dexmedetomidine on the Recovery Quality and Analgesia After Thyroid Cancer Surgery: A Randomized Controlled Trial Shu, Teng Xu, Siqi Ju, Xia Hu, Shenghong Wang, Shengbin Ma, Li Pain Ther Original Research INTRODUCTION: Surgical management is commonly used for thyroid cancer. We evaluated the effects of systemic lidocaine versus dexmedetomidine on the recovery quality and analgesia after thyroid cancer surgery. METHODS: A total of 120 patients with thyroid cancer were randomly allocated to group L (received lidocaine 1.5 mg/kg loading, continuously infused 1.5 mg/kg per hour), group D (received dexmedetomidine 0.5 µg/kg loading, continuously infused 0.5 µg/kg per hour) and group C (received normal saline), with 40 cases in each group. Anaesthesia induction and maintenance were performed using target-controlled infusions (TCIs) of propofol and remifentanil. The primary outcome of the quality of recovery-15 (QoR-15) score was recorded on the day before surgery and postoperative day 1 (POD1). Secondary outcomes included the consumption of remifentanil during surgery, time to first required rescue analgesia, number of patients requiring rescue analgesia, postoperative cumulative consumption of tramadol, visual analogue scale (VAS) pain score, incidence of postoperative nausea or vomiting (PONV) and side effects. RESULTS: The total score of the QoR-15 at POD1 (median, IQR) was higher in group L (128.0, 122.0–132.8) and group D (127.5, 122.5–132.5) compared to group C (118.5, 113.0–123.5) (P = 0.000). Compared to group C, systemic lidocaine and dexmedetomidine reduced cumulative consumption of remifentanil and VAS pain score (P = 0.000). The time to first required rescue analgesia (mean, SD) was longer in group L (8.1 h, 1.2 h) and group D (8.5 h, 1.9 h) than group C (5.9 h, 0.9 h) (P = 0.000). The number of patients requiring rescue analgesia was lower in group L (8/40, 20%) and group D (6/40, 15%) than group C (16/40, 40%) (P = 0.029), and cumulative consumption of tramadol (mean, SD) was lower in group L (44.0 mg, 17.1 mg) and group D (51.7 mg, 14.1 mg) than group C (73.9 mg, 18.4 mg) (P = 0.000). The incidence of PONV in group L (7/40, 17.5%) and group D (9/40, 22.5%) was lower than group C (18/40, 45.0%) (P = 0.016). Bradycardia (heart rate  less than 50 beats/min or lower) was noted in 25 patients (25/40, 62.5%), which was reversed by intravenous administration of atropine 0.5 mg. CONCLUSION: Systemic lidocaine and dexmedetomidine had similar effects on enhancing the quality of recovery, alleviating the intensity of pain and reducing the incidence of PONV after thyroid cancer surgery. However, dexmedetomidine may result in bradycardia. Therefore, lidocaine was superior to dexmedetomidine. TRIAL REGISTRATION: ChiCTR.org.cn (ChiCTR2000038442). Registered on September 22, 2020. Springer Healthcare 2022-10-06 2022-12 /pmc/articles/PMC9633913/ /pubmed/36203077 http://dx.doi.org/10.1007/s40122-022-00442-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Shu, Teng
Xu, Siqi
Ju, Xia
Hu, Shenghong
Wang, Shengbin
Ma, Li
Effects of Systemic Lidocaine Versus Dexmedetomidine on the Recovery Quality and Analgesia After Thyroid Cancer Surgery: A Randomized Controlled Trial
title Effects of Systemic Lidocaine Versus Dexmedetomidine on the Recovery Quality and Analgesia After Thyroid Cancer Surgery: A Randomized Controlled Trial
title_full Effects of Systemic Lidocaine Versus Dexmedetomidine on the Recovery Quality and Analgesia After Thyroid Cancer Surgery: A Randomized Controlled Trial
title_fullStr Effects of Systemic Lidocaine Versus Dexmedetomidine on the Recovery Quality and Analgesia After Thyroid Cancer Surgery: A Randomized Controlled Trial
title_full_unstemmed Effects of Systemic Lidocaine Versus Dexmedetomidine on the Recovery Quality and Analgesia After Thyroid Cancer Surgery: A Randomized Controlled Trial
title_short Effects of Systemic Lidocaine Versus Dexmedetomidine on the Recovery Quality and Analgesia After Thyroid Cancer Surgery: A Randomized Controlled Trial
title_sort effects of systemic lidocaine versus dexmedetomidine on the recovery quality and analgesia after thyroid cancer surgery: a randomized controlled trial
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633913/
https://www.ncbi.nlm.nih.gov/pubmed/36203077
http://dx.doi.org/10.1007/s40122-022-00442-5
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