Effect of different doses of lidocaine on recovery quality of patients with iodine-deficiency goiter after general anesthesia resection / 中华地方病学杂志

ABSTRACT

Objective:To explore the effect of different doses of lidocaine on recovery quality of patients with iodine-deficiency goiter after general anesthesia resection.Methods:Using a prospective design, 108 patients who underwent iodine-deficiency goiter resection in Yantai Yeda Hospital from April 2018 to April 2020 were selected as the research subjects. The patients were divided into control group (normal saline), lidocaine group A (1 mg/kg) and lidocaine group B (2 mg/kg) by random number table method, 36 cases in each group. The corresponding dose of lidocaine or the equivalent dose of normal saline was pumped into the vein after anesthesia induction and intubation for 30 minutes. The changes in the diastolic blood pressure (DBP), systolic blood pressure (SBP) and blood glucose (GLU) levels of the three groups were observed before administration, immediately after the operation, immediately after opening the eyes, immediately after extubation, and 10 minutes after extubation; at the same time, arousal and restlessness score (RS), sedation score (Ramsay), visual analogue score (VAS) and adverse reactions(coughing, nausea and vomiting, respiratory depression) occurrence were recorded.Results:At the moment of eye opening, immediately after extubation and 10 minutes after extubation, DBP (mmHg 77.26 ± 4.85, 73.45 ± 4.37, 70.94 ± 4.45, 83.53 ± 6.19, 77.86 ± 5.33, 74.14 ± 5.20, 73.86 ± 5.73, 68.41 ± 5.16, 63.09 ± 5.24), SBP (mmHg 129.17 ± 6.54, 121.25 ± 6.07, 116.24 ± 5.86, 137.48 ± 6.62, 129.53 ± 6.38, 123.07 ± 6.25, 125.65 ± 6.13, 117.48 ± 6.09, 108.17 ± 6.04), GLU level (mmol/L 5.83 ± 0.36, 5.37 ± 0.29, 5.12 ± 0.26, 6.69 ± 0.34, 5.84 ± 0.30, 5.57 ± 0.27, 5.61 ± 0.32, 5.25 ± 0.31, 4.97 ± 0.28) of lidocaine group A and lidocaine group B were significantly lower than those of control group, the difference were statistically significant ( F=17.520, 25.755, 36.034, 41.028, 45.525, 74.330, 10.397, 49.756, 52.348, P < 0.05); among them, the DBP, SBP and GLU levels of lidocaine group A and lidocaine group B were lower than those of control group, and lidocaine group B was lower than lidocaine group A ( P < 0.05). The RS and VAS of lidocaine group A and lidocaine group B were significantly lower than those of control group, and Ramsay was higher than that of control group ( P < 0.05); and the RS and VAS of lidocaine group B were lower than those of lidocaine group A, the Ramsay was higher than that of lidocaine group A ( P < 0.05). The incidence of coughing, nausea and vomiting in lidocaine group A and lidocaine group B were lower than those in the control group ( P < 0.05); and there was no respiratory depression in the three groups. Conclusions:Thrity minutes after induction of anesthesia, continuous pumping of 2 mg/kg lidocaine can maintain blood pressure and GLU of patients undergoing general anesthesia for iodine-deficiency goiter, and effectively reduce restlessness, pain and adverse reactions during the recovery period. It is a satisfactory dose for thyroid surgery patients to wake up and comfortably.