Perioperative intravenous lidocaine as an analgesic adjunct in adolescent idiopathic scoliosis surgery.

IF 0.9 4区 医学 Q4 ORTHOPEDICS
Mohd Shahnaz Hasan, Prahbodhamuralhi Selvanathan, Zheng-Yii Lee, Chee Kidd Chiu, Chris Yin Wei Chan, Mun Keong Kwan, Siti Nadzrah Yunus
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引用次数: 0

Abstract

Opioids are the mainstay of pain management in scoliosis surgery. We hypothesized that in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) surgery, perioperative intravenous (IV) lidocaine would reduce postoperative opioid requirement and pain scores. In this retrospective observational before-and-after study, we identified AIS patients who underwent single-stage PSF at a tertiary university hospital from 2020 to 2022. All patients received total intravenous anesthesia. The Lidocaine group received a bolus of 1.5 mg/kg IV lidocaine prior to induction, followed by infusion at 2 mg/kg/h. At wound closure, the rate was reduced to 1 mg/kg/h and continued for 30 min in recovery. All patients received patient-controlled analgesia (PCA) morphine postoperatively. The primary outcome was total morphine consumption in the first 24 h. The secondary outcome was mean pain scores over 48 h using a numerical rating scale. We included 115 patients: 59 in the Usual Care group and 56 in the Lidocaine group. Postoperative morphine use in the first 24 h showed no significant difference (Lidocaine: 13.5 ± 8.9 mg vs Usual Care: 13.9 ± 10.6 mg; P  = 0.821). The cumulative morphine milligram equivalents per kilogram bodyweight at 48 h was 0.43 mg/kg. Mean pain scores were higher in the Lidocaine group in the first 48 h (4.25 ± 0.37 vs 3.67 ± 1.46; P  = 0.03). Perioperative IV lidocaine administered as an analgesic adjunct for AIS surgery did not reduce postoperative morphine requirement. Although pain scores were statistically higher in patients receiving intravenous lidocaine, the difference was minimal and lacked clinical significance.

围手术期静脉注射利多卡因在青少年特发性脊柱侧凸手术中的镇痛辅助作用。
阿片类药物是脊柱侧凸手术疼痛管理的主要手段。我们假设,在接受后路脊柱融合术(PSF)的青少年特发性脊柱侧凸(AIS)患者中,围手术期静脉注射(IV)利多卡因可以减少术后阿片类药物的需求和疼痛评分。在这项回顾性前后观察研究中,我们确定了2020年至2022年在某三级大学医院接受单期PSF的AIS患者。所有患者均接受全静脉麻醉。利多卡因组诱导前静脉注射利多卡因1.5 mg/kg,诱导后静脉滴注利多卡因2 mg/kg/h。在伤口关闭时,速率降至1 mg/kg/h,并在恢复时持续30分钟。所有患者术后均给予自控镇痛吗啡(PCA)。主要结果是前24小时的吗啡总用量。次要结果是48小时内使用数值评定量表的平均疼痛评分。我们纳入了115例患者:常规护理组59例,利多卡因组56例。术后前24 h吗啡使用无显著差异(利多卡因:13.5±8.9 mg与常规护理:13.9±10.6 mg;p = 0.821)。48小时每公斤体重累积吗啡毫克当量为0.43 mg/kg。利多卡因组前48 h平均疼痛评分较高(4.25±0.37 vs 3.67±1.46;p = 0.03)。围手术期静脉注射利多卡因作为AIS手术的镇痛辅助并没有减少术后吗啡的需求。虽然静脉注射利多卡因患者的疼痛评分在统计学上较高,但差异很小,缺乏临床意义。
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来源期刊
CiteScore
2.20
自引率
9.10%
发文量
170
审稿时长
4-8 weeks
期刊介绍: The journal highlights important recent developments from the world''s leading clinical and research institutions. The journal publishes peer-reviewed papers on the diagnosis and treatment of pediatric orthopedic disorders. It is the official journal of IFPOS (International Federation of Paediatric Orthopaedic Societies). Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool. ​
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