Novosti
Khirurgii

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Year 2021 Vol. 29 No 2

ANESTHESIOLOGY-REANIMATOLOGY

V.A. ZHIKHAREV 1, A.M. BOSTANOVA 1, A.S. BUSHUEV 1, V.A. KORYACHKIN 2, V.A. PORKHANOV 1

INTRAVENOUS INFUSIONS OF LIDOCAINE IN SURGERY OF THE TRACHEA

Research Institute - Krasnodar Regional Clinical Hospital No1 Named by Professor S. V. Ochapovsky 1, Krasnodar
Saint-Petersburg State Pediatric Medical University 2, Saint-Petersburg,
The Russian Federation

Objective. To evaluate the possibility of using intravenous infusion of lidocaine in tracheal surgery.
Methods. The analysis of case histories of patients (n=19) operated on for tracheal stenosis was carried out. Depending on the perioperative analgesia, the patients were divided into two groups: the 1st group (n=9) – intravenous infusion of lidocaine; the 2nd – (n = 10) – narcotic analgesics. Tracheal resection was carried out using the cervical access. Before tracheal transection and after tracheal anastomosis was applied, protective mechanical ventilation of the lungs was performed. The stage of tracheal resection and formation of anastomosis is high-frequency jet ventilation (HFJV). Anesthesia was maintained with sevoflurane, and after opening the tracheal lumen – with propofol 6-8 mg/kg/h. In the first group, an intravenous bolus of lidocaine 1.5 mg / kg was added to the induction, followed by a continuous infusion of 1.5 mg / kg / h during surgery. The concentration of lidocaine was determined 15 minutes after the bolus and 24 h after surgery. Hemodynamics, acid-base state, glycemia, response to the endotracheal tube, time of extubation, occurrence of postoperative nausea and vomiting were assessed. Pain syndrome was assessed using a visual analogue scale every 15 minutes for an hour, and then every 4 hours until the end of the first day, the consumption of opioids was recorded.
Results. Group 1 patients were extubated without agitation; the pressor response to extubation was less pronounced. Mean arterial pressure, blood gas composition and glycemia did not differ between these groups. There were no signs of systemic toxicity of lidocaine. Group 1 patients did not need promedol and tramadol, and the median and percentiles in group 2 patients, both for promedol and tramadol, were 60 [30; 60] and 400 [200; 400] mg, respectively. Four patients in group 2 had postoperative nausea and vomiting.
Conclusion. Intravenous infusion of lidocaineis considered to be an alternative to perioperative opioid analgesia in tracheal surgery performed from the cervical approach.

Keywords: intravenous infusion of lidocaine, thoracic surgery, tracheal surgery, tracheal stenosis, tracheal resection, postoperative analgesia, post-operative nausea and vomiting
p. 198-206 of the original issue
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Address for correspondence:
350081, Russian Federation, Krasnodar,
1 May Str., 167 Research Institute-Regional Clinical Hospital No1 Named after Professor
S. V. Ochapovsky, the Department
of Anesthesiology and Resuscitation
tel. mob.:+7 903450-77-56
vasilii290873@yandex.ru
Zhikharev Vasilij A.
Information about the authors:
Zhikharev Vasilij A., PhD, Senior Clinical Intern, the Department of Anesthesiology and Resuscitation No1, Research Institute - Regional Clinical Hospital No1 Named after Professor S.V. Ochapovsky, Krasnodar, Russian Federation.
http://orcid.org/0000-0001-5147-5637
Bostanova Alina M., Clinical Intern, the Department of Anesthesiology and Resuscitation No1, Research Institute-Regional Clinical Hospital No1 named after Professor S.V. Ochapovsky, Krasnodar, Russian Federation.
http://orcid.org/0000-0002-2151-0611
Porkhanov Vladimir A., MD, Professor, Academician of RAS, Head Physician, Research Institute-Regional Clinical Hospital No1 Named after Professor S. V. Ochapovsky, Head of the Oncology Department with the Course of Thoracic Surgery of the Faculty of Advanced Training and Retraining of Specialists, Krasnodar, Russian Federation.
http://orcid.org/0000-0003-0572-1395
Koryachkin Viktor A., MD, Professor of the Department of Anesthesiology, Resuscitation and Urgent Pediatrics Department of Faculty of Postgraduate and Additional Professional Education, Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation.
http://orcid.org/0000-0002-3400-8989
Bushuev Alexander S., Clinical Intern, the Department of Anesthesiology and Resuscitation, Research Institute-Regional Clinical Hospital No1 named after Professor S. V. Ochapovsky, Krasnodar, Russian Federation.
http://orcid.org/0000-0002-1427-4032
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