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The effect of continuous intravenous lidocaine infusion on postoperative
analgesia in elderly patients undergoing laparoscopic colorectal surgery
#MMPMID41266981
Wan Q
; Yi Q
; Huang R
; Wang N
; Zeng Q
BMC Anesthesiol
2025[Nov]; 25
(1
): 579
PMID41266981
show ga
BACKGROUND: This study aimed to evaluate the effect of continuous intravenous
infusion of different doses of lidocaine on postoperative analgesia in elderly
patients undergoing laparoscopic colorectal surgery. METHODS: In this
prospective, randomized, double-blind pilot study, elderly patients undergoing
laparoscopic colorectal surgery at the Affiliated Cancer Hospital of Guizhou
Medical University between January 2024 and February 2025 were enrolled. All
patients received anterior quadratus lumborum block under ultrasound guidance
combined with general anesthesia. Participants were randomized into three groups
based on the lidocaine infusion dose after tracheal intubation: Group L
(1.0 mg/kg/h), Group M (1.5 mg/kg/h), and Group H (2.0 mg/kg/h). The primary
outcome was postoperative pain intensity assessed by the Numeric Rating Scale
(NRS) at predefined time points. Secondary outcomes included patient-controlled
analgesia (PCA) usage, postoperative opioid consumption, requirement of
intraoperative ephedrine, Modified Observer?s Assessment of Alertness/Sedation
(MOAA/S) scores, and incidence of postoperative adverse events. RESULTS: A total
of 114 patients aged???65 years (52 males and 62 females) were included with 38
cases in each group. Baseline demographic and clinical characteristics were
comparable among the three groups. There were significant differences in
postoperative pain NRS scores at 12-hour and 24-hour among three groups (both
P?0.001). Compared with the L group, the postoperative 12-hour and 24-hour pain
NRS scores were significantly lower in both the M and H groups (P?0.05)
Compared to Group L, both Group M and Group H demonstrated significantly reduced
cumulative PCA usage and postoperative opioid consumption (P?0.05). Group H
showed a higher requirement for intraoperative ephedrine compared to Groups L and
M (P?0.05). Upon entry into the post-anesthesia care unit, Groups L and M had
significantly higher MOAA/S scores than Group H (P?0.05). No significant
differences were found in the incidence of adverse events among three groups
(P?>?0.05). CONCLUSION: In elderly patients undergoing laparoscopic colorectal
surgery, continuous intravenous lidocaine infusion at 2.0 mg/kg/h significantly
reduced postoperative pain intensity at 12 and 24 h compared with 1.0 mg/kg/h.
Based on these findings, the effective dosage range appears to be
1.5?2.0 mg/kg/h. Further studies with larger sample sizes are needed to confirm
these results. CLINICAL TRIAL NUMBER: ChiCTR2500097315 (Retrospectively
registered).