静脉注射利多卡因和镁提高女性患者甲状腺手术的麻醉后恢复质量

Intravenously Administered Lidocaine and Magnesium During Thyroid Surgery in Female Patients for Better Quality of Recovery After Anesthesia

目的

虽然利多卡因和镁作为围手术期镇痛剂已被广泛研究，但在相同条件下很少对其恢复质量进行评估。我们比较了在甲状腺切除术中接受静脉注射利多卡因、镁和生理盐水的女性患者的恢复质量QoR-40评分，以研究它们对麻醉综合康复效果的影响。

方法

在这项前瞻性双盲试验中，135名拟进行开胸甲状腺切除术的女性患者被随机分配为利多卡因组（L组）、镁组（M组）或对照组（C组）。诱导后立即给予L组利多卡因（2 mg / kg，15分钟，然后2 mg / kg / h泵注），M组硫酸镁（20 mg / kg，15分钟后20 mg / kg / h泵注）。C组给予同等剂量的生理盐水。在术后第1天和第2天进行QoR-40评估。

结 果

术后第1天的平均QoR-40评分为L组186.3（标准差5.5），M组为184.3（4.7），C组为179.4（17.8），并且仅在L组和C组之间存在明显差异（平均差异，6.9;校正P = .018）。在QoR-40的5个维度中，L组的情绪状态、身体舒适度和疼痛程度均优于C组。

结 论

与C组相比，麻醉期间静脉注射利多卡因导致采用QoR-40测量的术后恢复质量更好。并发现以本研究中使用镁的剂量不足产生任何明显的改善。

原始文献摘要

Kim M H, Kim M S, Lee J H, et al. Intravenously Administered Lidocaine and Magnesium During Thyroid Surgery in Female Patients for Better Quality of Recovery After Anesthesia[J]. Anesthesia & Analgesia, 2018:1.

Abstract：

BACKGROUND:

Although systemic lidocaine and magnesium have been widely studied as perioperative analgesic adjuvants, they have been rarely evaluated with respect to recovery quality under the same conditions. We compared the quality of recovery 40 (QoR-40) scores of female patients who received intravenous lidocaine, magnesium, and saline during thyroidectomy to investigate their effects on comprehensive recovery from anesthesia.

METHODS:

In this prospective, double-blind trial, 135 female patients scheduled for open thyroidectomy were randomly assigned to the lidocaine group (group L), magnesium group (group M), or control group (group C). Immediately after induction, lidocaine (2 mg/kg for 15 minutes followed by 2 mg/kg/h) was administered in group L and magnesium sulfate (20 mg/kg over 15 minutes followed by 20 mg/kg/h) was administered in group M. Group C received an equivalent volume of saline. The QoR-40 survey was conducted on postoperative days 1 and 2.

RESULTS:

The mean global QoR-40 scores on postoperative day 1 were 186.3 (standard deviation, 5.5) in group L, 184.3 (4.7) in group M, and 179.4 (17.8) in group C, and there was a significant difference only between group L and group C (mean difference, 6.9; adjusted P = .018). Among the 5 dimensions of QoR-40, emotional state, physical comfort, and pain were superior in group L compared to group C.

CONCLUSIONS:

Lidocaine administered intravenously during anesthesia led to better quality of postoperative recovery measured by QoR-40 compared with the group C. Magnesium was found to be insufficient to induce any significant improvement with the dose used in the present study.