Effect of Intravenous Infusion Lidocaine and Laryngeal Mask Combined with Bronchial Blocker in Thoracoscopic Partial Lobectomy on Quality of Recovery and Postoperative Sore Throat
WANG Liping, SUN Yanbin, GUAN Sen, et al
Chengde Central Hospital, Hebei Chengde 067000, China
Abstract:Objective: To investigate the effect of intravenous lidocaine combined with laryngeal mask airway (LMA) and bronchial blocker on postoperative sore throat and recovery quality in patients undergoing video-assisted thoracoscopic (VATS) partial lung resection. Methods: A total of 75 patients scheduled for elective VATS partial lung resection in our hospital from July 2023 to June 2024 were selected, with American Society of Anesthesiologists (ASA) physical status classification Ⅰ~Ⅲ, body mass index (BMI) 18.0-30.0 kg/m2, and age 18-65 years. According to the random number table method, the patients were divided into three groups with 25 cases in each group: endotracheal intubation combined with bronchial blocker group (Group E), LMA combined with bronchial blocker group (Group B), and lidocaine combined with LMA and bronchial blocker group (Group L). Group E achieved lung isolation using endotracheal intubation combined with a bronchial blocker, while Groups B and L performed lung isolation with LMA combined with a bronchial blocker. For Group L, a loading dose of 1.5mg/kg lidocaine was intravenously pumped 15 minutes before anesthesia induction, followed by continuous intravenous pumping of lidocaine at 1.5mg/kg/h during anesthesia maintenance until the end of the operation; Groups E and B were pumped with the same dose of normal saline instead of lidocaine, and the remaining treatments were identical among the three groups. The following parameters were observed and recorded: Quality of Recovery-15 (QoR-15) scores before surgery, at 24 hours and 48 hours after surgery; Visual Analogue Scale (VAS) scores for postoperative sore throat; mean arterial pressure (MAP) and heart rate (HR) at the time points of before surgery (T0), immediately after insertion of the lung isolation device (T1), skin incision (T2), start of one-lung ventilation (T3), end of one-lung ventilation (T4), and extubation (T5); serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) before surgery, at 24 hours and 48 hours after surgery; intraoperative dosages of propofol and remifentanil; number of presses of patient-controlled intravenous analgesia (PCIA) pump within 48 hours after surgery; and incidence of postoperative adverse reactions. Results: Compared with Group E, the QoR-15 scores at 24 hours after surgery in Groups B and L were significantly higher, and the QoR-15 score of Group L at 48 hours after surgery was higher than that of Group B; the VAS scores for postoperative sore throat in Groups L and B were significantly lower, and the score of Group L was lower than that of Group B; the fluctuations of MAP and HR at T1 and T5 in Groups L and B were smaller; at 24 hours and 48 hours after surgery, the serum levels of IL-6 and CRP in Groups L and B were decreased; the intraoperative dosage of remifentanil in Group L was reduced; and the number of PCIA pump presses in Group L after surgery was decreased, which was fewer than that in Group B. Conclusion: Intravenous lidocaine combined with LMA and bronchial blocker in VATS partial lung resection is beneficial for postoperative recovery of patients and can alleviate postoperative sore throat.
王莉萍, 孙艳斌, 关森, 赵振儒, 边晶, 王曌, 王建雄. 静注利多卡因联合喉罩支气管封堵器肺隔离对胸腔镜肺部分切除术术后咽痛及恢复质量的影响[J]. 河北医学, 2025, 31(12): 2093-2099.
WANG Liping, SUN Yanbin, GUAN Sen, et al. Effect of Intravenous Infusion Lidocaine and Laryngeal Mask Combined with Bronchial Blocker in Thoracoscopic Partial Lobectomy on Quality of Recovery and Postoperative Sore Throat. HeBei Med, 2025, 31(12): 2093-2099.
[1] Xiang YY,Chen Q,Tang XX,et al.Comparison of the effect of double-lumen endotracheal tubes and bronchial blockers on lung collapse in video-assisted thoracoscopic surgery: a systematic review and meta-analysis[J].BMC Anesthesiol,2022,22(1):330. [2] Taniguchi T,Fujii T,Taniguchi N,et al.Risk factors for postoperative sore throat associated with i-gel,a supraglottic airway device[J].Nagoya Med Sci,2022,84(2):319-326. [3] Myles PS,Shulman MA,Reilly J,et al.Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis[J].Br Anaesth,2022,128(6):1029-1039. [4] Chhabra A,Dave M,Jeenger L,et al.Comparison of Quality of Recovery (QoR-15) following the administration of intravenous lignocaine and fentanyl in patients undergoing septoplasty under general anaesthesia: A double-blinded,randomised,controlled trial[J].Indian Anaesth,2023,67(4):388-393. [5] Wei Q,Xia M,Zhang Q,et al.Effect of intravenous lidocaine infusion on perioperative cellular immunity and the quality of postoperative recovery in breast cancer patients: a randomized controlled trial[J].Gland Surg,2022,11(3):599-610. [6] Leger M,Campfort M,Cayla C,et al.Postoperative quality of recovery measurements as endpoints in comparative anaesthesia studies: a systematic review[J].Br Anaesth,2021,126(6):210-212. [7] Bi X,Wen J,Chen Q,et al.Effects of thermal softening of double-lumen endobronchial tubes on the prevention of postoperative sore throat in smokers: a randomized controlled trial[J].Cardiothorac Vasc Anesth,2022,36(8):3109-3113. [8] R S,M N,L D,et al.Could Disease severity and inflammatory markers (IL-6,Hs-CRP,TNF-α) be related to frailty in COPD A prospective study[J].Assoc Physicians India,2022,70(4):11-12. [9] Mogahed MM,Elkahwagy MS.Paravertebral block versus intercostal nerve block in non-intubated uniportal video-assisted thoracoscopic surgery: a randomised controlled trial[J].Heart Lung Circ,2020,29(5):800-807. [10] 李华,张卓亮,段陈夏,等.小剂量艾司氯胺酮复合舒芬太尼术后镇痛对老年患者髋关节置换术后早期认知功能的影响[J].临床麻醉学杂志,2022,38(9):936-939.