Lidocaine-Based vs Sufentanil-Based PCIA After Pulmonary Resection Surgery: A Randomized Controlled Trial

Area of Science:

• Anesthesiology
• Pain Management
• Thoracic Surgery

Background:

• Postoperative pain management is crucial for recovery after thoracoscopic lung surgery.
• Patient-controlled intravenous analgesia (PCIA) is a common method for managing surgical pain.
• Comparing different analgesic agents for PCIA is essential to optimize patient outcomes.

Purpose of the Study:

• To compare the efficacy and safety of lidocaine-based PCIA versus sufentanil-based PCIA.
• To evaluate the impact on postoperative pain and quality of recovery in patients undergoing thoracoscopic lung surgery.
• To assess various recovery parameters and inflammatory markers.

Main Methods:

• A randomized study involving 160 patients undergoing thoracoscopic lung surgery.
• Patients received either lidocaine-based PCIA (1.5 mg/kg/h) or sufentanil-based PCIA (2 μg/mL).
• Primary endpoint was visual analogue scale (VAS) pain scores; secondary endpoints included quality of recovery-15 (QoR-15) scores, time to recovery milestones, and inflammatory markers.

Main Results:

• Lidocaine PCIA demonstrated significantly lower VAS pain scores at 6, 12, and 24 hours postoperatively.
• Higher QoR-15 scores and improved physical comfort and pain dimensions were observed in the lidocaine group.
• The lidocaine group showed a shorter time to first flatus, defecation, and ambulation, with lower levels of inflammatory markers (IL-6, TNF-α, IL-8) and reduced postoperative nausea and vomiting.

Conclusions:

• Lidocaine-based PCIA is more effective than sufentanil-based PCIA in managing postoperative pain after thoracoscopic lung surgery.
• Lidocaine PCIA significantly improves the quality of recovery and reduces adverse events like nausea and vomiting.
• Lidocaine-based PCIA presents a considerable and advantageous option for postoperative analgesia in this patient population.