PDF(Pubmed)
Abstract：
UNASSIGNED: We hypothesised that a continuous 72-h bilateral parasternal infusion of lidocaine at 2×35 mg h-1 would decrease pain and the inflammatory response after sternotomy for open heart surgery, subsequently improving quality of recovery.
UNASSIGNED: We randomly allocated 45 participants to a 72-h bilateral parasternal infusion of lidocaine or saline commencing after wound closure. The primary outcome was the cumulative patient-controlled analgesia (PCA) morphine consumption at 72 h. Secondary outcomes included total morphine requirement, pain, peak expiratory flow, and serum interleukin-6 concentration. In addition, we used an eHealth platform for a 3-month follow-up of pain, analgesic use, and Quality of Recovery-15 scores.
UNASSIGNED: The 72-h PCA morphine requirement was significantly lower in the lidocaine than the saline group (10 mg [inter-quartile range: 5-19 mg] and 28.2 mg [inter-quartile range: 16-42.5 mg], respectively; P=0.014). The total morphine requirement (including morphine administered before the start of PCA) was significantly lower at 24, 48, and 72 h. Pain was well controlled with no difference in pain scores between treatment groups. The peak expiratory flow was lower in the lidocaine group at 72 h. Interleukin-6 concentrations showed no difference at 24, 48, or 72 h. Quality of Recovery-15 scores did not differ between treatment groups at any time during the 3-month follow-up.
UNASSIGNED: After sternotomy for open heart surgery, a 72-h bilateral parasternal lidocaine infusion significantly decreased PCA and total morphine requirement. However, neither signs of decreased inflammatory response nor an improvement in recovery was seen.
UNASSIGNED: EudraCT number 2018-004672-35.
UNASSIGNED: We randomly allocated 45 participants to a 72-h bilateral parasternal infusion of lidocaine or saline commencing after wound closure. The primary outcome was the cumulative patient-controlled analgesia (PCA) morphine consumption at 72 h. Secondary outcomes included total morphine requirement, pain, peak expiratory flow, and serum interleukin-6 concentration. In addition, we used an eHealth platform for a 3-month follow-up of pain, analgesic use, and Quality of Recovery-15 scores.
UNASSIGNED: The 72-h PCA morphine requirement was significantly lower in the lidocaine than the saline group (10 mg [inter-quartile range: 5-19 mg] and 28.2 mg [inter-quartile range: 16-42.5 mg], respectively; P=0.014). The total morphine requirement (including morphine administered before the start of PCA) was significantly lower at 24, 48, and 72 h. Pain was well controlled with no difference in pain scores between treatment groups. The peak expiratory flow was lower in the lidocaine group at 72 h. Interleukin-6 concentrations showed no difference at 24, 48, or 72 h. Quality of Recovery-15 scores did not differ between treatment groups at any time during the 3-month follow-up.
UNASSIGNED: After sternotomy for open heart surgery, a 72-h bilateral parasternal lidocaine infusion significantly decreased PCA and total morphine requirement. However, neither signs of decreased inflammatory response nor an improvement in recovery was seen.
UNASSIGNED: EudraCT number 2018-004672-35.
摘要：
■我们假设连续72小时双侧胸骨旁输注2×35mgh-1的利多卡因可以减轻胸骨切开术后的疼痛和炎症反应。随后提高恢复质量。
■我们将45名参与者随机分配到伤口闭合后开始的72小时双侧胸骨旁输注利多卡因或生理盐水。主要结果是72h时患者自控镇痛（PCA）吗啡的累积消耗量。次要结果包括总吗啡需求，疼痛,呼气流量峰值,和血清白细胞介素-6浓度。此外,我们使用eHealth平台进行了3个月的疼痛随访，镇痛药的使用，和恢复质量-15评分。
■利多卡因的72小时PCA吗啡需求量明显低于盐水组（10mg[四分位数间：5-19mg]和28.2mg[四分位数间：16-42.5mg]，分别；P=0.014)。在24、48和72h时，吗啡的总需求量（包括PCA开始前的吗啡）显着降低。疼痛得到了很好的控制，治疗组之间的疼痛评分没有差异。利多卡因组在72h时的呼气流量峰值较低。白细胞介素-6浓度在24、48或72h时无差异。在3个月的随访中，治疗组之间的恢复质量-15评分在任何时间均无差异。
■胸骨切开心脏直视手术后，72小时的双侧胸骨旁利多卡因输注显着降低了PCA和总吗啡需求。然而,既未发现炎症反应降低的迹象,也未发现恢复改善.
■欧盟编号2018-004672-35。
■我们将45名参与者随机分配到伤口闭合后开始的72小时双侧胸骨旁输注利多卡因或生理盐水。主要结果是72h时患者自控镇痛（PCA）吗啡的累积消耗量。次要结果包括总吗啡需求，疼痛,呼气流量峰值,和血清白细胞介素-6浓度。此外,我们使用eHealth平台进行了3个月的疼痛随访，镇痛药的使用，和恢复质量-15评分。
■利多卡因的72小时PCA吗啡需求量明显低于盐水组（10mg[四分位数间：5-19mg]和28.2mg[四分位数间：16-42.5mg]，分别；P=0.014)。在24、48和72h时，吗啡的总需求量（包括PCA开始前的吗啡）显着降低。疼痛得到了很好的控制，治疗组之间的疼痛评分没有差异。利多卡因组在72h时的呼气流量峰值较低。白细胞介素-6浓度在24、48或72h时无差异。在3个月的随访中，治疗组之间的恢复质量-15评分在任何时间均无差异。
■胸骨切开心脏直视手术后，72小时的双侧胸骨旁利多卡因输注显着降低了PCA和总吗啡需求。然而,既未发现炎症反应降低的迹象,也未发现恢复改善.
■欧盟编号2018-004672-35。
