Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2023.64.222
Effects of an intravenous lidocaine bolus before tracheal extubation on recovery after breast surgery – Lidocaine at the End (LATE) study: a randomized controlled clinical trial
Boris Mraovic
orcid.org/0000-0003-4019-4084
; Department of Anesthesiology & Perioperative Medicine, University of Missouri – Columbia, Columbia, Missour
*
Tatjana Šimurina
; Department of Health Studies, University of Zadar, Zadar, Croatia
* Dopisni autor.
Sažetak
Aim To investigate whether IV lidocaine improves emergence, early recovery, and late recovery after general anesthesia in women who undergo breast surgery.
Methods Sixty-seven women with American Society of
Anesthesiologists physical status I-II, scheduled for breast
surgery were randomized to receive an IV lidocaine 1.5
mg/kg bolus (n=34) or saline placebo (n=33) before tracheal extubation. Anesthesia was induced with thiopental,
vecuronium, and fentanyl, and maintained with sevoflurane~1 MAC and 50% nitrous-oxide in oxygen. No postoperative nausea and vomiting (PONV) prophylaxis was
given. Time to extubation, bucking before extubation, and
quality of emergence, as well as early and late recovery
(coughing post-extubation, sore throat, PONV, and pain
scores) within 24 hours postoperatively were evaluated.
Diclofenac and meperidine were used for the treatment of
pain and metoclopramide for PONV.
Results The groups did not significantly differ in demographics, intraoperative data, or PONV risk scores. Extubation was~8 minutes in both groups. Patients who received
IV lidocaine had significantly smoother recovery, both statistically and clinically; they had better extubation quality
scores (1.5 [1-3] vs 3 [1-5], P<0.001), less bucking before
extubation (38% vs 91%, P<0.001), less coughing after extubation (at 1 min 18% vs 42%, P=0.026; and at 24 hours
9% vs 27%, P=0.049), and less sore throat (6% vs 48%,
P<0.001). Late PONV decreased (3% vs 24%, P=0.013).
There were no differences in pain scores and treatment.
Conclusion In women who underwent breast surgery,
IV lidocaine bolus administered just before extubation attenuated bucking, cough and sore throat, and PONV for
24 hours after general anesthesia, without prolonging the
emergence.
Ključne riječi
Hrčak ID:
331548
URI
Datum izdavanja:
31.8.2023.
Posjeta: 359 *