The Application Of Patient-controlled Intravenous Analgesia With Lidocaine In Patients After Liver Surgery

Objective：To investigate the analgesic effect of lidocaine combined withfentanyl and tramadol for patient-controlled intravenous analgesia (PCIA) in thepatients after liver surgery, as well as the impact on postoperative recovery.Methods：60patients underwent selective liver resection under generalanesthesia, were randomly allocated into three groups,20people in each group.Group A (self-controlled analgesic experimental group). Fentanyl0.5mg plustramadol500mg and lidocaine200mg complex solution to150ml. Group B(self-controlled analgesic group), Fentanyl0.5mg plus tramadol500mg complexsolution to150ml. Group C (traditional analgesic group), intramuscular injectiontramadol or pethidine will be needed in for analgesia if necessary according tothe patients.All patients used the same surgical and anesthesia. And after the surgery, a postoperative analgesia will be made based on the analgesic methodfor each group. Postoperative pain was evaluated by visual analog score(VAS),VAS was measured at rest and during coughing at2hr、4hr、8hr、24hr、48hr and72hr postoperatively. The number of PCA press times, as well as the times tofirst flatus, score sedation, the number of nausea and vomiting were recorded.Blood samples were drawn to measure liver function(ALT and AST)、renalfunction(BUN and Cr) and arterial blood gas analysis(ABG) at the day beforesurgery and after surgery at24and72h.Results：Group A had significantly lower VAS than group B(P＜0.05).There is no significant difference in analgesic for Group A comparing withGroup B. The time to first flatus in Group A was significantly less comparedwith Group B (P＜0.05), no significant difference happens between Group Aand Group C. The ALT、AST、BUN and Cr values showed no significantdifference among three groups at24h and72h after surgery. The function ofpulmonary ventilation was no significant difference between group A and B.Conclusion: After partial hepatectomy, to add lidocaine in PCIA can notimpact on postoperative liver, renal and respiratory function, postoperative painVAS when resting and postoperative opium consumption. But it can shorten thefirst flatus time, accelerate the recovery of bowel function, and alleviatepostoperative pain when coughing.