肺切除手術後の術後の合併症および炎症に対する手術後のパラvertebralまたは静脈注入リドカインの効果: ランダム化比較試験
Francisco de la Gala1, Elena de la Fuente2, Patricia Piñeiro1
1Department of Anaesthesiology, Gregorio Marañón University Hospital, Madrid, Spain; Biomedical Research Institute, Gregorio Marañón University Hospital, Madrid, Spain.
British journal of anaesthesia
|September 2, 2025
まとめ
肺切除手術後の合併症と炎症は,レミフェンタニルと比較して,静脈内またはパラvertebral catheter を通して投与された. これはリドカインを強調しています.
科学分野:
- 麻酔科 と 集中治療 科
- 胸部 外科
- 薬理学について
背景:
- 肺切除後の合併症を減らすためのリドカインの抗炎症性は未評価です.
- この研究では,肺切除手術後の合併症を緩和する手術中のリドカインの有効性を調べました.
研究 の 目的:
- 肺切除後の合併症をリミフェンタニルと比較して減少させるかどうかを評価する.
- リドカイン投与に関連した肺および全身の炎症反応を定量化するために.
主な方法:
- ビデオアシスタントの胸腔切除を施した患者の単一センターでのランダム化試験です.
- 参加者はIVリドカイン/パラvertebral塩分,パラvertebralリドカイン/IV塩分,またはレミフェンタニル/パラvertebral塩分を投与された.
- 合併症はクラヴィエン・ディンド分類を用いて評価され,肺膜洗浄液と血におけるサイトカイン濃度が測定された.
主要な成果:
- レミフェンタニル (11. 8%) と比較して,パラvertebral (4. 1%) またはIV (3. 7%) リドカインで発生した重大な合併症 (Clavien- Dindo Grade ≥III) は少なかった.
- リドカインはレミフェンタニルと比較して重症合併症 (OR: 0. 44) と肺合併症 (OR: 0. 35) を有意に減少させた.
- リドカインを投与した患者では,片肺換気後により低いサイトカイン濃度が観察されました.
結論:
- 術内リドカインは,レミフェンタニルと比較して,肺切除後の合併症の発生率と重症度を効果的に軽減します.
- リドカインの利点は,全身および肺の炎症を軽減する能力から生じる可能性があります.
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