静脉注射利多卡因预防儿童术后呕吐(POV)的剂量反应尚不清楚。这项研究调查了接受扁桃体切除术(有或没有腺样体切除术)而无严重并发症的儿童术后24小时内静脉注射利多卡因剂量依赖性地降低POV风险。从2021年12月至2022年3月,计划进行选择性扁桃体切除术(有或没有腺样体切除术)的3-12岁(美国麻醉医师协会I-II级)患者。根据利多卡因剂量(A[0mgkg-1],B[1mgkg-1],C[1.5mgkg-1],和D[2mgkg-1]),并按照相同的诱导方案(舒芬太尼,异丙酚,和氯化三甲铵)。用七氟醚维持麻醉。术后24h内POV的发生率在A组中分别为46、40、36和20%,B,C,D,分别,D组与A组术后镇痛抢救比较差异有统计学意义,B,C,D分别为62%、36%、34%和16%,分别,D组和B组之间存在显着差异,C和A,D和A.未报告严重不良事件。静脉注射利多卡因具有剂量依赖性作用,可以降低接受扁桃体切除术(有或没有腺样体切除术)的儿童的POV风险,而没有严重的不良事件。试验注册:中国临床试验注册中心,ChiCTR2100053006。
The dose-response of intravenous lidocaine in preventing postoperative vomiting (POV) in children remains unclear. This study investigated whether intravenous lidocaine dose-dependently decreased POV risk within 24 h postoperatively in children undergoing tonsillectomy (with or without
adenoidectomy) without severe complications. Patients aged 3-12 years (American Society of Anesthesiologists grade I-II) scheduled for elective tonsillectomy (with or without
adenoidectomy) were enroled from December 2021 to March 2022. They were randomly grouped according to the lidocaine dose (A [0 mg kg-1], B [1 mg kg-1], C [1.5 mg kg-1], and D [2 mg kg-1]) and were administered the same induction protocol (sufentanil, propofol, and suxamethonium chloride). Anaesthesia was maintained with sevoflurane. The incidence of POV within 24 h postoperatively was 46, 40, 36, and 20% in groups A, B, C, and D, respectively, with significant differences between groups D and A. Postoperative analgesic rescues in groups A, B, C, and D were 62, 36, 34, and 16%, respectively, with significant differences between groups D and B, C and A, and D and A. No severe adverse events were reported. Intravenous lidocaine has a dose-dependent effect on reducing the risk of POV in children undergoing tonsillectomy (with or without
adenoidectomy) without serious adverse events.Trial registration: Chinese Clinical Trial Registry, ChiCTR2100053006.