Intravenous Lidocaine Modulates The Perioperative Hepatic Inflammatory Response: Implications For Personalized Medicine In Thoracic Surgery

Purpose: Lung resection surgery increases the expression of proinflammatory mediators and cause initially a local inflammatory response that later spreads to the bloodstream and affects peripheral organs, including the liver. The main goal of this study was to investigate the effect of intravenous lidocaine on the liver systemic inflammatory response during lung resection surgery with one lung ventilation. Methods: A total of 18 mini pigs were equally divided in three groups: lidocaine, control and sham group. All the animals underwent left caudal lobectomy under general anesthesia, using one lung ventilation in lido and control group, in the sham group a thoracotomy was performed without lobectomy or OLV. Different samples were collected from blood at different moments; before and after OLV, at the end of surgery and 24 h after the surgery. Liver biopsy was taken 24h after de surgery. We performed measurements of multiple mediators in the liver biopsy to compare the effect of intravenous lidocaine administration in the inflammatory response. Results: One-lung ventilation and lung resection surgery cause an increase in the release of pro-inflammatory markers measured in liver biopsy, it also increases apoptotic proteins expression and production of iNOS. Conclusion: Our findings suggest that intravenous lidocaine may serve as a personalized perioperative strategy to attenuate systemic inflammatory responses, contributing to precision approaches in thoracic anesthesia and surgery.