Pulmonary Protective Effect Of Intravenous Infusion Of Lidocaine On Patients Undergoing One Lung Ventilation

Objective:To evaluate the efficacy and safety of intravenous infusion of different doses of lidocaine on lung protection in patients undergoing one lung ventilation surgery.Methods:120 patients undergoing thoracoscopic pneumonectomy under general anesthesia were randomly divided into three groups:control group(Group C),low-dose lidocaine(Group LL)and high-dose lidocaine group(Group LH).Group LH:lidocaine 1.5mg/kg was injected intravenously after anesthesia induction,and then pumped at the rate of 2mg/kg·h until the skin suture was completed.Group LL:lidocaine lmg/kg was injected intravenously after anesthesia induction,and then pumped at the rate of 1mg/kg·h until the skin suture was completed.Group C:after anesthesia induction,0.1ml/kg normal saline was injected intravenously,and then pumped at the rate of 0.1ml/kg·h until the skin suture was completed.The three groups were managed with the same preoperative and postoperative scheme,and the single lung ventilation technique was used during the operation.The main result is the effect of lidocaine on oxygenation.The secondary outcome was the effect of lidocaine on postoperative lung injury,postoperative pulmonary complications and postoperative inflammatory cell count.The indexes of pulmonary mechanics and hemodynamics,extubation time,anesthesia awakening time,postoperative hospital stay and adverse events were recorded.Results:After the recovery of double lung ventilation,the oxygenation index of LL and LH groups was significantly higher than that of group C(P<0.05),the peak airway pressure and driving pressure of LL and LH groups were significantly lower than that of group C(P<0.05),but no significant difference was observed between LL and LH groups(P>0.05).There was no significant difference in the incidence of 24-hour lung injury and postoperative pulmonary complications among the three groups(P>0.05).There was no significant difference in leukocyte count at 24 hours after operation among the three groups(P>0.05).The neutrophil count and neutrophil percentage in LL and LH groups were significantly lower than those in group C(P<0.05),but there was no significant difference between LL and LH groups(P>0.05).There was no significant difference in anesthesia depth and hemodynamic indexes among the three groups(P>0.05).The extubation time of LL and LH groups was significantly shorter than that of C group(P<0.05),but there was no significant difference between LL and LH groups(P>0.05).There was no significant difference in recovery time and postoperative hospital stay among the three groups(P>0.05).Conclusion:Intravenous infusion of lidocaine can improve oxygenation and pulmonary mechanics in patients undergoing one lung ventilation surgery,and arch lifting has a certain pulmonary protective effect.Whether it has clinical related benefits needs to be further studied.