| Objective:To explore the effect of intravenous lidocaine on the early renal function of patients after laparoscopic partial nephrectomy and its role in postoperative rehabilitation.Methods:A total of 63 patients undergoing elective laparoscopic partial nephrectomy in the First Affiliated Hospital of Nanchang University,aged 18-70 years,with ASA grade II-III,weight > 40 kg,were divided into group R(lidocaine group)and group C(normal saline control group)according to random number table method.After induction by conventional general anesthesia in Group R,5% lidocaine 1.5mg/kg was injected slowly intravenously within 5 minutes,and then pumped continuously at a rate of 1 mg/(kg·h)until the end of surgery.Group C was subjected to 1.5mg/kg normal saline intravenously 5 minutes after induction of conventional general anesthesia,and continued pumping at a rate of 1mg/(kg·h)until the end of surgery,and ECG,pulse oximetry,arterial blood pressure,central venous pressure,EEG dual-frequency index and other indicators were routinely monitored in both groups.The average arterial blood pressure(MAP)and heart rate(HR)at the time of the patient’s excision(T0),10 min after the start of surgery(T1),when the skin is sutured(T2),at the end of the operation(T3)are recorded;Central venous blood was collected 24 to 48 hours before and after surgery to quantitatively detect the concentration of serum creatinine,cystatin-C and neutrophil gelatinase-related lipid carrying protein,and estimate the glomerular filtration rate.VAS scores at extubation and 24 to 48 hours after surgery,as well as postoperative recovery indicators(time to eat,time to get out of bed,length of hospital stay,incidence of nausea and vomiting)were recorded.Results:In this study,63 patients undergoing laparoscopic partial nephrectomy in the First Affiliated Hospital of Nanchang University were selected,of which 4 patients withdrew from the study due to missing data,midway withdrawal or intraoperative persistent hypotension,and a total of 59 patients completed the study.There were no significant differences in gender,age,ASA grade,anesthesia time,operation time and blood loss between group R and group C(P>0.05),and there was no significant difference in mean arterial pressure and heart rate at various time points between the two groups(P>0.05).There was no difference in preoperative serum creatinine,cystatin c,NGAL,and glomerular filtration rate between the two groups(P>0.05),and the concentration of cystatin C in group R was lower than that in group C at 24 and 48 hours after surgery,and the concentration of NGAL in 24 hours after surgery was also lower than in group C(P<0.05).There was no difference in creatinine and glomerular filtration rate at each time after surgery(P>0.05),and the VAS pain score in group R was lower than that in group C at extubation(P<0.05),and there was no difference in score between the two groups at 24 hours and 48 hours after surgery(P>0.05),and there was no difference in intraoperative hemodynamic indexes and the incidence of postoperative eating,getting out of bed,hospitalization time and nausea and vomiting between the two groups(P>0.05).Conclusion:Perioperative intravenous infusion of lidocaine can reduce postoperative kidney injury in patients undergoing laparoscopic partial nephrectomy,play a role in renal protection,and reduce early postoperative pain;However,no superiority was shown in the observation of postoperative rehabilitation indicators. |
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