The goal of this clinical trial is to learn about the effects on postoperative analgesia of continuous lidocaine infusion via closed chest drainage tube for patients undergoing thoracoscopic partial lung resection. The main questions it aims to answer are: * To explore whether continuous lidocaine pumping via closed chest drainage tube has good analgesic and anti-inflammatory effects for patients undergoing partial thoracoscopic pneumonectomy. * Whether the multimodal analgesia combined with continuous lidocaine pump can reduce the postoperative application of opioids, reduce the occurrence of postoperative complications, and promote the recovery of postoperative lung function and accelerate recovery. For participants who undergoing the thoracoscopic partial lung resection with postoperative indwelling drainage tube, the epidural tube fixed in the drainage tube is connected to the completed infusion pump (marking the chest drain for analgesia). The comparison group only accept the intravenous analgesia after surgery.
At present, multimodal analgesia has been the most commonly used approaches for the treatment of postoperative pain of thoracic surgery, including steroidal anti-inflammatory drugs, administration of opioid, and local anesthesia. The investigators found that continuous lidocaine analgesia with local anesthesia through thoracic closed drainage tube could improve postoperative pain caused by drainage tube retention, reduce postoperative pain score, and improve postoperative recovery of respiratory function in patients. In the protocol, lidocaine was continuously pumped with a superficial anesthetic effect on the pleura, while mucosal absorption was almost equivalent to intravenous infusion, so its systemic anti-inflammatory effect is also explored. In the protocol,participants will be randomized in a 1:1 ratio to the control or experimental groups. The experimental group received a continuous infusion of lidocaineThe experimental group used 2% lidocaine 100ml, and the control group was the conventional treatment group. The control group received only standard intravenous analgesia。In addition to receiving simple intravenous analgesia, the experimental group also received continuous infusion of lidocaine in the pleural cavity.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
451
Continuous intrapleural infusion via epidural tube fixed in the closed chest drainage tube, connected to an electronic analgesic pump (pulse 1 mL/30 min + continuous 2 mL/h).
Patient-controlled intravenous analgesia (PCIA): reduced dose 1.0-1.5 µg/kg in the lidocaine arm, standard dose 2.0-2.5 µg/kg in the control arm, both for 48 h.
Qilu Hospital
Jinan, Shandong, China
postoperative pain score(NRS)
The primary outcome is the incidence of a numeric rating scale (NRS) pain score \> 3 on coughing/movement at 24 hours postoperatively (movement-evoked pain only).
Time frame: Day 1
Changes in postoperative pain
Changes in postoperative pain score (NRS) at 12h and 48h until extubation. The full name of NRS score is Numerical Rating Scale. The minimum value of NRS score is 0 and the maximum value is 10. Patients can score themselves according to the pain level corresponding to the number, A score of 0 represents painless, 1-3 represents mild pain, 4-6 represents moderate pain and should be intervened, 7-10 represents severe pain and requires urgent treatment.
Time frame: Day 2
the use of flurbiprofen axetil
the amount of rescue analgesic drugs flurbiprofen axetil used
Time frame: Day 3
the use of dolantin
the amount of rescue analgesic drugs dolantin used
Time frame: Day 3
the use of opioids
total amount of opioid use within 48h after surgery
Time frame: Day 2
postoperative adverse events
the incidence of nausea, vomiting, and vertigo after surgery
Time frame: Day 3
the amount of postoperative wound drainage
total amount of fluid drained after surgery
Time frame: Day 3
C-reactive protein
The inflammatory marker of participants will be test after surgery
Time frame: Day 1
interleukin-6
The inflammatory marker of participants will be test after surgery
Time frame: Day 1
postoperative delusion
The incidence of postoperative delusion.
Time frame: Day 3
drainage extraction
The time taken for the patient to remove the drain after surgery
Time frame: up to 24 hours (before extubation)
ICU stay time
The length of time the patient remains in the ICU.
Time frame: From date of ICU admission until the date of leaving ICU, assessed up to 5 days.
postoperative pulmonary complications
The probability of patients acquiring pulmonary complications after surgery.
Time frame: Day 3
hospital length of stay
The time between hospital admission and discharge
Time frame: From date of hospital admission until the date of discharge,assessed up to 15 days.
healing rate of drainage wound
The healing rate of drainage wound at 21 days after surgery.
Time frame: Day 21
readmission rate
The readmission rate of patients in one month after surgery.
Time frame: Month 1
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