Purpose: To evaluate the effectiveness and safety of lidocaine on postoperative quality of recovery and lung protection of patients undergoing thoracoscopic radical resection of lung cancer.
Patients and Methods: Seventy ASA II–III patients undergoing thoracoscopic radical resection of lung cancer were randomly assigned into either the lidocaine group (Group L) or control group (Group C). Patients in Group L received lidocaine with a 1.5 mg/kg bolus before induction of anesthesia, followed by 2.0 mg/kg/h until the end of the operation while the patients in Group C received volume-matched normal saline at the same rate. The main outcome was the quality of recovery-40 score (QoR-40 score) at 24 h postoperatively. The peak airway pressure (Ppeak) and plateau airway pressure (Pplat), the partial pressure of oxygen in arterial blood (PaO₂), partial pressure of carbon dioxide in arterial blood (PaCO₂), alveolar-arterial oxygen gradient (A-aDO2), oxygenation index (OI), time to first flatus and defecation, intraoperative hemodynamics and opioid consumption were also recorded.
Results: There were no statistically difference at patients’ baseline characteristics. The QoR-40 score of Group L was significantly higher than that of Group C at 24 h after surgery (P =0.014). Ppeak, Pplat, and A-aDO₂ of Group L were significantly lower than those of Group C (P < 0.001, P < 0.001, P =0.025, respectively) after the ventilation recovery of both lungs, and the PaO₂ and OI of the Group L were significantly higher than those of Group C (P =0.027, P =0.027, respectively). Time to first flatus and defecation in Group L was significantly lower compared with Group C (P =0.037, P =0.025, respectively).
Conclusion: Intravenous lidocaine can improve the quality of recovery of patients undergoing thoracoscopic radical resection of lung cancer, while also providing lung protection, favorable postoperative analgesia, a reduction in the time to first flatus and defecation after surgery.
Keywords: lidocaine, quality of recovery, lung-protective effects, radical resection of lung cancer