Effect of intravenous lidocaine infusion on postoperative pain and inflammatory factors in patients undergoing thoracic surgery

Objective To observe the effects of intravenous lidocaine infusion on postoperative pain and inflammatory factors in patients undergoing thoracic surgery. Methods 120 patients undergoing thoracoscopic lobectomy were randomly divided into groups A, B and C, with 40 cases in each group. Group A received intravenous lidocaine 1.0 mg/kg during anesthesia induction, continued to pump lidocaine 1.5 mg/kg•h during the operation until the end of the operation, and continued to pump lidocaine 0.2 mg/kg•h after surgery until 48 hours after surgery; Group B received intravenous lidocaine 1.0 mg/kg during induction of anesthesia and continued to pump lidocaine 1.5 mg/kg•h during operation until the end of operation; Group C was given equal volume of normal saline. VAS pain scores were recorded after extubation, 30 min after extubation, when leaving PACU, 24 h after surgery and 48 h after surgery. Coughing during extubation, postoperative nausea and vomiting, additional postoperative analgesics, number of analgesic pump compressions, first time to exhaust gas, first time to get out of bed, length of hospital stay and postoperative QoR15 score were measured. Serum levels of procalcitonin and IL-6 were measured by intravenous blood samples before and 48 h after operation. Results Compared with group C, VAS scores in group A and group B were significantly decreased 30min after extubation, after leaving PACU, 24h and 48h after surgery (P < 0.017). The incidence of coughing during extubation was decreased (P < 0.05), the first time of getting out of bed was significantly shortened (P < 0.017), the levels of procalcitonin and IL-6 were significantly decreased 24h after extubation (P < 0.017), and the score of QoR15 was significantly increased (P < 0.017). There were no significant differences in VAS score after extubation, incidence of postoperative nausea and vomiting, additional analgesic drugs and the number of analgesic pump compression, first postoperative exhaust time and postoperative hospital stay among three groups (P > 0.05). Conclusion Intravenous infusion of lidocaine can effectively relieve postoperative pain and reduce the level of postoperative inflammatory factors in patients undergoing thoracic surgery. Trial registration Chinese Clinical Trial Registry, ChiCTR2300078858, 20/12/2023.