Background:This meta-analysis aimed to assess the efficiency and safety of intravenous infusion of lidocaine for pain management after laparoscopic cholecystectomy (LC).Methods:A systematic search was performed in PubMed (August 1966–2017), Medline (August 1966–2017), Embase (August 1980–2017), ScienceDirect (August 1985–2017), and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Meta-analysis was performed using Stata.11.0 software.Results:A total of 5 RCTs were retrieved involving 274 patients. The present meta-analysis indicated that there were significant differences between groups in terms of visual analog scale scores at 12hours (weighted mean difference [WMD]=−0.743, 95% CI: −1.246 to −0.240, P = .004), 24hours (WMD=−0.712, 95% CI: −1.239 to −0.184, P = .008), and 48hours (WMD=−0.600, 95% CI: −0.972 to −0.229, P = .002) after LC. Significant differences were found regarding opioid consumption at 12hours (WMD=−3.136, 95% CI: −5.591 to −0.680, P = .012), 24hours (WMD=−4.739, 95% CI: −8.291 to −1.188, P = .009), and 48hours (WMD=−3.408, 95% CI: −5.489 to −1.326, P = .001) after LC.Conclusion:Intravenous lidocaine infusion significantly reduced postoperative pain scores and opioid consumption after LC. In addition, there were fewer adverse effects in the lidocaine groups. Higher quality RCTs are still required for further research.
Objective. To evaluate the protective effect of target-directed fluid therapy on the lungs and postoperative rehabilitation in elderly patients with single-lung ventilation undergoing total endoscopic radical resection of esophageal cancer. Methods. Seventy elderly patients who underwent total endoscopic radical resection of esophageal cancer from January 2017 to December 2019 in our hospital were selected and divided into two groups by the random number table method: the goal-directed fluid treatment group (group G, n = 35) and the control group (group C, n = 35). Venous blood was extracted before surgery (T1), at the end of free esophagus (T2) by thoracoscopy, at the end of abdominal surgery (T3), and at the end of surgery (T4). IL-6 and IL-10 levels were detected by ELISA. The clinical pulmonary infection score (CIPS) was used to evaluate the pulmonary inflammation on the second day after surgery and the occurrence of complications. Duration of antibiotic use and length of hospital stay were recorded. Results. At T1, there were no significant differences in IL-6 and IL-10 levels between the two groups ( P > 0.05 ). At T2, the IL-6 level in group G increased to 26.65 ± 1.80 pg/ml but was significantly lower than that in group C (32.28 ± 3.22 pg/ml) ( P < 0.01 ). At T3 and T4, IL-6 and IL-10 levels in group G were significantly lower than those in group C ( P < 0.01 ). The CIPS score of group G was lower than that of group C (1.5 ± 1.0 vs 2.7 ± 1.4), and the duration of antibiotic use in group G was shorter than that in group C (211.2 ± 15.4 vs 232.6 ± 18.7 h), with statistical significance ( P < 0.01 ). The incidence of complications in group G was lower than that in group C (28.6% vs 40.0%), and the length of hospital stay in group G was shorter than that in group C (10.5 ± 1.7 vs 11.2 ± 1.9 days), but there was no significant difference between the two groups ( P > 0.05 ). Conclusion. Target-directed fluid therapy inhibited inflammatory cytokine levels and had better lung protection, but no significant benefit in the complications or the length of hospital stay was observed.
Objective: To explore the effects of goal-directed fluid therapy (GDFT) on lung function, cognitive function and inflammatory response in patients undergoing radical esophageal cancer surgery under one-lung ventilation. Methods: Sixty-seven patients undergoing radical esophageal cancer surgery were divided into GDFT group (GDFT therapy) and control group (conventional liquid therapy). The changes in patients' pulmonary function, cognitive function and inflammatory response were evaluated. Results: Both alveolar-arterial oxygen partial pressure difference [P(A-a)O 2 ] and respiratory index (RI) increased at one-lung ventilation for 30 minutes (T 2 ) and decreased at one-lung ventilation for 60 minutes (T 3 ), and after surgery (T 4 ) in the two groups, and the GDFT group was lower than the control group (P < 0.05); theoxygenation index (OI) of the two groups decreased at T 2 , T 3 , and T 4 compared with that at T 1 (before one-lung ventilation), and the GDFT group was higher than the control group (P < 0.05). At T 4 and T 5 , the tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), central nervous system specific protein (S100β), and neuron specific enolase (NSE) in the GDFT group were lower compared to the control group (P < 0.05), while interleukin-10 (IL-10) was higher compared to the control group (P < 0.05); the incidence of perioperative neurocognitive disorder (PND) in the GDFT group was lower than that in the control group (P < 0.05). Conclusion: GDFT can help prevent lung injury during radical esophageal cancer surgery under one-lung ventilation, reduce the body's inflammatory response,
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