静脉输注利多卡因对肺癌VATS全麻患者术后炎症反应及早期认知功能的影响OA

Objective:To observe the effects of intravenous lidocaine on postoperative inflammatory response and early cognitive function in patients with lung cancer un-dergoing video-assisted thoracoscopic surgery(VATS)under general anesthesia.Methods:A total of 126 lung cancer pa-tients who underwent general anesthesia for VATS in our hospital from January 2022 to December 2024 were enrolled and ran-domly divided into two groups using a random number table.The lidocaine group received an intravenous injection of lido-caine 1.5 mg/kg before anesthesia induction,maintained at 2.0 mg·kg-1·h-1,while the placebo group received the same amount of normal saline before anesthesia induction and after intubation.General surgical conditions,high-sensitivity C-reac-tive protein(hs-CRP),interleukin-6(IL-6),central nervous system-specific protein(S100β),high-sensitivity cardiac tro-ponin T(hs-cTnT),Visual Analogue Scale(VAS)score,incidence of postoperative delirium,Mini-Mental State Examina-tion(MMSE)score,and incidence of cardiac adverse events were compared between the two groups.Results:The dosages of propofol and remifentanil in the lidocaine group[(414.74±72.65)mg,(2.57±0.42)mg]were lower than those in the placebo group[(498.56±85.96)mg,(3.11±0.48)mg].The recovery time in the lidocaine group[(11.25±2.21)min]and the stay duration in the post-anesthesia care unit[(33.21±7.06)min]were shorter than those in the placebo group[(12.10±2.33)min,(35.86±6.74)min](P<0.05).Compared with preoperative levels,the levels of hs-CRP,IL-6,S100β,and hs-cTnT at 24 h and 72 h postoperatively were elevated in both groups.However,the lido-caine group showed lower levels of hs-CRP[(23.44±4.18)mg/L at 24 h,(14.47±4.05)mg/L at 72 h],IL-6[(56.98±15.44)pg/mL at 24 h,(39.86±8.06)pg/mL at 72 h],S100β[(253.65±40.75)pg/mL at 24 h,(241.63±34.41)pg/mL at 72 h],and hs-cTnT[(8.41±2.06)ng/L at 24 h]than those in the placebo group at the same time points[hs CRP:(28.98±5.95)mg/L at 24 h,(19.98±4.63)mg/L at 72 h;IL-6:(67.15±16.98)pg/mL at 24 h,(48.41±12.47)pg/mL at 72 h;S100β:(324.14±38.59)pg/mL at 24 h,(287.74±40.58)pg/mL at 72 h;hs-cTnT:(9.85±2.24)ng/L at 24 h](P<0.05).The VAS scores at 12 h,24 h,and 48 h in the lidocaine group were lower than those in the placebo group(P<0.05).Compared with preoperative levels,the MMSE score in the placebo group decreased at 72 h,and the MMSE score in the lidocaine group at 72 h[(27.84±1.24)points]was higher than that in the placebo group[(27.12±1.31)points](P<0.05).The incidences of postoperative delirium and arrhyth-mia in the lidocaine group were 6.35%and 1.59%,respectively,which were lower than those in the placebo group(19.35%and 12.90%,respectively)(P<0.05).Conclusion:Intravenous lidocaine in the general anesthesia for VATS lung cancer surgery can reduce the intraoperative consumption of propofol and remifentanil during the operation,optimize the quality of anesthesia,reduces the levels of hs-CRP,IL-6,S100β,and hs-cTnT,and lower the incidences of postoperative delirium and arrhythmia.