Effect of lidocaine or dexmedetomidine on postoperative recovery in elder patients undergoing colorectal surgery

作者全名："Qin, Peipei; Wei, Ke; Yang, Qian; Zhu, Yiziting; Zheng, Xiaozhuo; Zhang, Hongyu"

作者地址："[Qin, Peipei; Wei, Ke; Yang, Qian; Zhu, Yiziting; Zheng, Xiaozhuo] Chongqing Med Univ, Dept Anesthesiol, Affiliated Hosp 1, Chongqing, Peoples R China; [Zhang, Hongyu] Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, Chongqing, Peoples R China; [Wei, Ke] Chongqing Med Univ, Dept Anesthesiol, Affiliated Hosp 1, Rd Youyi Rd 1, Chongqing 400016, Peoples R China"

通信作者："Wei, K (通讯作者)，Chongqing Med Univ, Dept Anesthesiol, Affiliated Hosp 1, Rd Youyi Rd 1, Chongqing 400016, Peoples R China."

来源：MINERVA ANESTESIOLOGICA

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000994260000006

JCR分区：Q1

影响因子：2.9

年份：2023

卷号：89

期号：5

开始页：405

结束页：414

文献类型：Article

关键词：Lidocaine; Dexmedetomidine; Colorectal neoplasms; Gastrointestinal motility

摘要："BACKGROUND: Opioid sparing techniques have been shown to promote gastrointestinal recovery, shorten length of stay (LOS), and reduce opioid-related complications. We investigated whether intraoperative intravenous lidocaine or dexmedetomidine infusion could improve gastrointestinal recovery in elderly patients undergoing laparoscopic colorectal surgery. METHODS: Ninety-six patients aged 65 years or older who underwent elective laparoscopic colorectal resection were randomly allocated into the following three groups: the control group (N.=32) received an equal volume of saline, the lidocaine group (N.=32) received intraoperative intravenous lidocaine infusion, and the dexmedetomidine group (N.=32) received intraoperative intravenous dexmedetomidine infusion. The primary outcome was time to first feces. Secondary outcomes were time to first flatus, postoperative pain intensity, patient-controlled intravenous analgesia (PCIA) consump-tion, postoperative inflammatory response, postoperative complications, anesthetic adverse events, and LOS. RESULTS: The lidocaine group had a significantly shorter time to first flatus (24.6 [IQR, 14.4-48.8] hours vs. 48.1 [IQR, 30.0-67.1] hours; adjusted P=0.022) and time to first feces (48.0 [IQR, 19.0-67.8] hours vs. 74.8 [IQR, 40.3-113.3] hours; adjusted P=0.032) than the control group. However, no significant differences were found between dexmedetomidine and control group for first flatus or first feces. Intraoperative sufentanil consumption and postoperative plasma concentrations of IL-6 were significantly lower in lidocaine group and dexmedetomidine group compared with control group. No differ-ence could be observed in postoperative PCIA consumption, pain scores, postoperative complications, anesthetic adverse events, and LOS among the groups. CONCLUSIONS: Intraoperative intravenous lidocaine infusion accelerated return of the bowel function in elderly pa-tients undergoing elective colorectal surgery."

基金机构："Chongqing Health Commission [2021MSXM146, 2022jstg026]"

基金资助正文："manuscript. Funding.-The present work was funded by the Chongqing Health Commission (project N. 2021MSXM146, 2022jstg026) ."