Systemic lidocaine versus erector spinae plane block for improving quality of recovery after laparoscopic cholecystectomy: A randomized controlled trial

被引：0

作者：

Lin, Zhiwei ^{[1
]}

Chen, Chanjuan ^{[2
]}

Xie, Shengyuan ^{[3
]}

Chen, Lei ^{[1
]}

Yao, Yusheng ^{[3
]}

Qian, Bin ^{[1
]}

机构：

[1] Fujian Univ Tradit Chinese Med, Peoples Hosp, Dept Anesthesiol, Fuzhou, Peoples R China

[2] Fujian Med Univ, Fujian Matern & Child Hlth Hosp, Coll Clin Med Obstet & Gynecol & Pediat, Dept Anesthesiol, Fuzhou, Peoples R China

[3] Fujian Med Univ, Shengli Clin Med Coll, Fujian Prov Hosp, Dept Anesthesiol, Fuzhou, Peoples R China

来源：

JOURNAL OF CLINICAL ANESTHESIA | 2024年 / 97卷

关键词：

Erector spinae plane block; Intravenous lidocaine; Laparoscopic cholecystectomy; Postoperative pain; Quality of recovery; INTRAVENOUS LIDOCAINE; POSTOPERATIVE QUALITY; SURGERY; PAIN; METAANALYSIS; DESIGN;

D O I：

10.1016/j.jclinane.2024.111528

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Study objective: To compare intravenous lidocaine, ultrasound-guided erector spinae plane block (ESPB), and placebo on the quality of recovery and analgesia after laparoscopic cholecystectomy. Design: A prospective, triple-arm, double-blind, randomized, placebo-controlled non-inferiority trial. Setting: A single tertiary academic medical center. Patients: 126 adults aged 18-65 years undergoing elective laparoscopic cholecystectomy. Interventions: Patients were randomly allocated to one of three groups: intravenous lidocaine infusion (1.5 mg/kg bolus followed by 2 mg/kg/h) plus bilateral ESPB with saline (25 mL per side); bilateral ESPB with 0.25% ropivacaine (25 ml per side) plus placebo infusion; or bilateral ESPB with saline (25 ml per side) plus placebo infusion. Measurements: The primary outcome was the 24-h postoperative Quality of Recovery-15 (QoR-15) score. The non-inferiority of lidocaine versus ESPB was assessed with a margin of -6 points and 97.5% confidence interval (CI). Secondary outcomes included 24-h area under the curve (AUC) for pain scores, morphine consumption, and adverse events. Main results: 124 patients completed the study. Median (IQR) 24-h QoR-15 scores were 123 (117-127) for lidocaine, 124 (119-126) for ESPB, and 112 (108-117) for placebo. Lidocaine was non-inferior to ESPB (median difference -1, 97.5% CI: -4 to infinity). Both lidocaine (median difference 9, 95% CI: 6-12, P < 0.001) and ESPB (median difference 10, 95% CI: 7-13, P < 0.001) were superior to placebo. AUC for pain scores and morphine use were lower with lidocaine and ESPB versus placebo (P < 0.001 for all), with no significant differences between lidocaine and ESPB. One ESPB patient reported a transient metallic taste; no other block-related complications occurred. Conclusions: For patients undergoing laparoscopic cholecystectomy, intravenous lidocaine provides a non-inferior quality of recovery compared to ESPB without requiring specialized regional anesthesia procedures. Lidocaine may offer a practical and accessible alternative within multimodal analgesia pathways.

引用

页数：7