肺癌术后胸膜腔不同浓度利多卡因浸润镇痛对患者康复的影响

李成林; 鲜正睿; 张乐; 梁静; 刘曙; 邱容

doi:10.11659/jjssx.03E023104

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肺癌术后胸膜腔不同浓度利多卡因浸润镇痛对患者康复的影响

临床研究 | 更新时间：2024-01-22

- 肺癌术后胸膜腔不同浓度利多卡因浸润镇痛对患者康复的影响
- Effects of different concentrations of lidocaine infiltration and analgesia in pleural cavity after lung cancer surgery on rehabilitation of patients
- 局解手术学杂志 2024年33卷第1期页码：69-72
- 作者机构：
  
  武警四川省总队医院胸外科，四川乐山 614000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.03E023104
  中图分类号： R734.2
- 纸质出版日期：2024-01-25，
  
  收稿日期：2023-03-16，
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李成林,鲜正睿,张乐等.肺癌术后胸膜腔不同浓度利多卡因浸润镇痛对患者康复的影响[J].局解手术学杂志,2024,33(01):69-72.

LI Cheng-lin,XIAN Zheng-rui,ZHANG Le,et al.Effects of different concentrations of lidocaine infiltration and analgesia in pleural cavity after lung cancer surgery on rehabilitation of patients[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(01):69-72.
李成林,鲜正睿,张乐等.肺癌术后胸膜腔不同浓度利多卡因浸润镇痛对患者康复的影响[J].局解手术学杂志,2024,33(01):69-72. DOI： 10.11659/jjssx.03E023104.

LI Cheng-lin,XIAN Zheng-rui,ZHANG Le,et al.Effects of different concentrations of lidocaine infiltration and analgesia in pleural cavity after lung cancer surgery on rehabilitation of patients[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(01):69-72. DOI： 10.11659/jjssx.03E023104.

摘要

目的

探讨肺癌术后胸膜腔不同浓度利多卡因浸润镇痛对患者康复的影响。

方法

选取我院收治的86例肺癌患者，按照随机数字表法分为高浓度组（43例）与低浓度组（43例）。高浓度组患者在术后第1天经硬膜外导管于胸膜腔内注入2.0%盐酸利多卡因，低浓度组患者于胸膜腔内注入1.5%盐酸利多卡因，2组患者术后均采取静脉自控镇痛。比较2组患者术后首次下床活动时间、首次排气时间、首次排便时间、住院时间，并比较术后6 h、12 h、24 h、48 h视觉模拟量表（VAS）评分，术后苏醒期躁动发生情况和术后24 h内镇痛泵按压次数、镇痛药物用量。术后24 h，记录2组患者药物不良反应发生情况，采用40项恢复质量评分量表（QoR-40）评估患者恢复质量。

结果

高浓度组患者术后首次下床活动时间、首次排气时间、首次排便时间、住院时间均短于低浓度组（

0.05）。2组患者术后12 h、24 h时VAS评分均高于术后6 h（

0.05），术后24 h、48 h时VAS评分低于术后12 h（

0.05），术后48 h时VAS评分均低于术后24 h（

0.05）；高浓度组患者术后6 h、12 h、24 h、48 h时VAS评分均低于低浓度组（

0.05）。高浓度组患者苏醒期躁动发生率和术后24 h内镇痛泵按压次数、镇痛药物用量均低/少于低浓度组（

0.05）。2组患者术后药物不良反应总发生率比较，差异无统计学意义（

0.05）。高浓度组患者QoR-40总分高于低浓度组（

0.05）。

结论

肺癌患者术后采用2.0%利多卡因胸膜腔浸润镇痛可减少患者苏醒期躁动，减轻术后疼痛，提高术后恢复质量，促进患者术后康复，且具有一定的安全性。

Abstract

Objective

To explore the effects of different concentrations of lidocaine infiltration and analgesia in pleural cavity after lung cancer surgery on rehabilitation of patients.

Methods

A total of 86 patients with lung cancer were selected and divided into the high concentration group （43 cases） and low concentration group （43 cases） by random number table method. Patients in the high concentration group received injection of 2.0% lidocaine hydrochloride in pleural cavity through the epidural catheter 1st day after surgery，and patients in the low concentration group received injection of 1.5% lidocaine hydrochloride in pleural cavity. In addition，patients in the two groups were treated with patient-controlled intravenous analgesia after surgery. The first time of getting out of bed，first time of exhaustion，first time of defecation and hospital stay after surgery of the two groups were compared. The visual analogue scale （VAS） scores 6 hours，12 hours，24 hours and 48 hours after surgery，the occurrence of agitation during the postoperative awakening period，and the number of analgesic pump compressions and the dosage of analgesic drugs within 24 hours after surgery were compared. The incidence of adverse drug reactions 24 hours after surgery were recorded and the quality of recovery of patients 24 hours after surgery was evaluated by 40-item quality of recovery score （QoR-40）.

Results

The first time of getting out of bed，first time of exhaustion，first time of defecation and hospital stay after operation of patients in the high concentration group were shorter than those in the low concentration group （

0.05）. The VAS scores of the two groups 12 hours and 24 hours after surgery were higher than those 6 hours after surgery （

0.05），the VAS scores 24 hours and 48 hours after surgery were lower than those 12 hours after surgery （

0.05），and the VAS scores 48 hours after surgery were lower than those 24 hours after surgery （

0.05）. The VAS scores 6 hours，12 hours，24 hours，and 48 hours after surgery of patients in the high concentration group were lower than those in the low concentration group （

0.05）. The occurrence of agitation during the postoperative awakening period，and the number of analgesic pump compressions and the dosage of analgesic drugs within 24 hours after surgery for patients in the high concentration group were lower/less than those in the low concentration group （

0.05）. There was no significant difference in the total incidence of adverse drug reactions between the two groups （

0.05）. The total QoR-40 score of patients in the high concentration group were higher than those in the low concentration group （

0.05）.

Conclusion

The use of 2.0% lidocaine infiltration and analgesia in pleural cavity for patients after lung cancer surgery can reduce the agitation during the awakening period，alleviate the postoperative pain，improve the quality of postoperative recovery，and promote the postoperative recovery of the patients，with certain safety.

关键词

肺癌利多卡因胸膜腔浸润麻醉康复

Keywords

lung cancerlidocainepleural cavityinfiltration anesthesiarecovery

references

张璐芳，于士昌，翟建宾，等.肠外营养联合肠内营养对肺癌术后化疗患者营养状况及免疫功能的影响［J］.局解手术学杂志，2022，31（11）：1013-1016.doi：10.11659/jjssx.04E022094http://dx.doi.org/10.11659/jjssx.04E022094.

Xu X，Cheung DST，Smith R，et al.The effectiveness of pre- and post-operative rehabilitation for lung cancer：a systematic review and meta-analysis on postoperative pulmonary complications and length of hospital stay［J］.Clin Rehabil，2022，36（2）：172-189.doi：10.1177/02692155211043267http://dx.doi.org/10.1177/02692155211043267.

Kamal F，Khan MA，Lee-Smith W，et al.Efficacy and safety of supplemental intravenous lidocaine for sedation in gastrointestinal endoscopic procedures：systematic review and meta-analysis of randomized controlled trials［J］.Gastrointest Endosc，2021，93（6）：1241-1249.doi：10.1016/j.gie.2021.01.008http://dx.doi.org/10.1016/j.gie.2021.01.008.

苏海霞，王晨光，王春燕.不同剂量利多卡因对腹腔镜子宫肌瘤切除术患者麻醉诱导时QTc的影响［J］.心脏杂志，2021，33（2）：165-168.doi：10.12125/j.chj.202101079http://dx.doi.org/10.12125/j.chj.202101079.

支修益，石远凯，于金明.中国原发性肺癌诊疗规范（2015年版）［J］.中华肿瘤杂志，2015，37（1）：67-78.doi：10.3760/cma.j.issn.0253-3766.2015.01.014http://dx.doi.org/10.3760/cma.j.issn.0253-3766.2015.01.014.

Mowafy SMS，Ellatif SEA.Effectiveness of nebulized dexmedetomidine for treatment of post-dural puncture headache in parturients undergoing elective cesarean section under spinal anesthesia： a randomized controlled study［J］.J Anesth，2021，35（4）：515-524.doi：10.1007/s00540-021-02944-6http://dx.doi.org/10.1007/s00540-021-02944-6.

宁光耀，陈杨，夏万里，等.单孔胸腔镜肺楔形切除术和单孔胸腔镜解剖性肺段切除术治疗早期肺癌的效果［J］.局解手术学杂志，2023，32（1）：36-40.doi：10.11659/jjssx.05E022095http://dx.doi.org/10.11659/jjssx.05E022095.

Wang Y，Wu G，Liu Z，et al.Effect of oxycodone combined with ultrasound-guided thoracic paravertebral nerve block on postoperative analgesia in patients with lung cancer undergoing thoracoscopic surgery： protocol for a randomised controlled study［J］.BMJ Open，2023，13（10）：74416.doi：10.1136/bmjopen-2023-074416http://dx.doi.org/10.1136/bmjopen-2023-074416.

王磊，孙静，张学广，等.利多卡因对胸腔镜下行肺癌根治术的患者术后恢复质量及肺保护作用的影响［J］.医学研究杂志，2021，50（4）：119-123.doi：10.11969/j.issn.1673-548X.2021.04.028http://dx.doi.org/10.11969/j.issn.1673-548X.2021.04.028.

Wang L，Sun J，Zhang X，et al.The effect of lidocaine on postoperative quality of recovery and lung protection of patients undergoing thoracoscopic radical resection of lung cancer［J］.Drug Des Devel Ther，2021，15（1）：1485-1493.doi：10.2147/DDDT.S297642http://dx.doi.org/10.2147/DDDT.S297642.

张宇，杨雪辉，葛增才，等.负荷量利多卡因浓度对硬膜外分娩镇痛效果的影响［J］.中国妇幼保健，2022，37（10）：1803-1805.doi：10.19829/j.zgfybj.issn.1001-4411.2022.10.018http://dx.doi.org/10.19829/j.zgfybj.issn.1001-4411.2022.10.018.

郝冬，张锦.利多卡因气雾剂复合利多卡因及丙泊酚静脉麻醉在无痛胃镜检查中的应用［J］.实用药物与临床，2021，24（2）：150-152.doi：10.14053/j.cnki.ppcr.202102011http://dx.doi.org/10.14053/j.cnki.ppcr.202102011.

Lu Y，Ding H，Shao C，et al.Effect of lidocaine perioperative infusion on chronic postsurgical pain in patients undergoing thoracoscopic radical pneumonectomy［J］.BMC Anesthesiol，2022，22（1）：255.doi：10.1186/s12871-022-01795-2http://dx.doi.org/10.1186/s12871-022-01795-2.

张绿秀，钱江洁，毛小萍，等.胸膜腔间断注射罗哌卡因在胸腔镜手术后镇痛中的应用［J］.浙江医学，2021，43（17）：1902-1904.doi：10.12056/j.issn.1006-2785.2021.43.17.2020-263http://dx.doi.org/10.12056/j.issn.1006-2785.2021.43.17.2020-263.

张觅，刘巍.癌症疼痛患者阿片类药物的滥用风险评估和管理［J］.医药导报，2021，40（1）：51-55.doi：10.3870/j.issn.1004-0781.2021.01.008http://dx.doi.org/10.3870/j.issn.1004-0781.2021.01.008.

张鹏，林辉，陈峰.不同剂量利多卡因对碘缺乏型甲状腺肿全麻切除术后患者恢复质量的影响［J］.中华地方病学杂志，2021，40（4）：321-325.doi：10.3760/cma.j.cn231583-20200826-00227http://dx.doi.org/10.3760/cma.j.cn231583-20200826-00227.

范筝，王海彬，刘中凯.术中持续静脉注射利多卡因对胸腔镜肺叶切除术患者术中麻醉用药及术后疼痛的影响［J］.国际麻醉学与复苏杂志，2022，43（3）：258-263.doi：10.3760/cma.j.cn321761-20210903-00498http://dx.doi.org/10.3760/cma.j.cn321761-20210903-00498.

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