Effects Of Intravenous Infusion Of Lidocaine And Dexmedetomidine On Recovery Quality Of Patients Following Thyroid Cancer Surgery: A Randomized Controlled

Objective Surgical treatment is commonly used for thyroid cancer.As an endocrine organ,the thyroid is important for the body’s metabolism and regulating hormone levels in the internal environment.In China and around the world,more and more people are suffering from thyroid cancer,the incidence tends to be younger,which has aroused widespread public concern about thyroid cancer.Moreover,such patients are easily affected by various adverse factors such as hormone levels in the body,the disease itself,the fear of operation and anesthesia which will cause adverse consequences such as pain,nausea and vomiting,depression,and sleep disorders,those consequences seriously affect the postoperative recovery.We evaluated the effects of intravenous lidocaine and dexmedetomidine infusion on the quality of patient recovery following thyroid cancer surgery.Methods A total of 120 thyroid cancer patients were randomly allocated to group L（received lidocaine 1.5 mg/kg loading,continuously infused 1.5 mg/kg/h）,group D（received dexmedetomidine 0.5 μg/kg loading,continuously infused 0.5 μg/kg/h）and group C（received normal saline）,with 40 cases in each group.To attain double-blinding,50-ml syringes containing lidocaine（12 mg/ml）,dexmedetomidine（4μg/ml）or saline were prefilled.Before anaesthesia induction,each patient received an intravenous infusion at a rate of 0.75 ml/kg/h over 10 minutes.This rate corresponded to1.5 mg/kg lidocaine or 0.5 μg/kg dexmedetomidine.Each patient received continuous infusions at a rate of 0.125 ml/kg/h until 30 minutes before the end of surgery,and this rate corresponded to 1.5 mg/kg/h of lidocaine and 0.5 μg/kg/h of dexmedetomidine.Anaesthesia induction and maintenance were performed using target-controlled infusions（TCIs）of propofol and remifentanil.Time to awareness,length of PACU stay,cumulative consumption of remifentanil,time to first rescue analgesia,postoperative tramadol consumption,VAS pain score,and incidence of PONV were the secondary outcomes.The incidence of PONV was assessed by the PONV intensity scale.A 10-cm VAS scale was used to rate the VAS pain score 2,4,8,12 and 24 h after surgery.Side effects,such as severe arrhythmia,bradycardia,hypotension,need for vasopressors were recorded.Results The total score of the Qo R-15 at POD1 was higher in group L and group D compared to group C（P<0.05）.Compared to group C,intravenous lidocaine and dexmedetomidine infusion reduced the cumulative consumption of remifentanil and the VAS pain score（P<0.05）.The time to first required rescue analgesia was longer in group L and group D than group C（P<0.05）.The number of patients requiring rescue analgesia was lower in group L and group D than group C（P<0.05）,and cumulative consumption of tramadol was lower in group L and group D than group C（P<0.05）.The incidence of PONV in group L and group D was lower than group C（P<0.05）.Bradycardia was noted in fifteen patients,which was reversed by intravenous atropine0.5 mg.Conclusion Lidocaine and dexmedetomidine had similar effects on enhancing the quality of recovery,alleviating the intensity of pain,and reducing the occurrence of PONV in patients following thyroid cancer surgery.However,dexmedetomidine may result in bradycardia.