A Randomized Double-Blind Trial Comparing Lidocaine and Dexmedetomidine Infusion and Their Combination on Perioperative Pain in Patients Undergoing Video-Assisted Thoracoscopic Surgery
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Ain Shams University
- Enrollment
- 75
- Locations
- 1
- Primary Endpoint
- Total morphine consumption
Study Overview
Brief Summary
This study aims to compare lidocaine and dexmedetomidine infusion and their combination on perioperative pain in patients undergoing video-assisted thoracoscopic surgery.
Detailed Description
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure allowing the reduction of surgical stress. However, postoperative pain management is crucial for patients undergoing VATS, as inadequate pain control can lead to complications (such as lung atelectasis), prolonged recovery, and decreased patient satisfaction.
Dexmedetomidine has shown positive effects on postoperative pain intensity, opioid consumption and other recovery parameters, such as postoperative nausea and vomiting (PONV), and speed of recovery.
Lidocaine has exhibited an excellent safety profile when administered as a low-dose infusion for cancer or non-cancer chronic pain.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age ≥18 years old.
- •Both sexes.
- •American Society of Anesthesiologists (ASA) physical status of I, II.
- •Patients undergoing video-assisted thoracoscopic surgery (VATS) under general anesthesia.
Exclusion Criteria
- •Hypersensitivity to any of the used drugs.
- •Coagulation disorder.
- •Body mass index >35 kg/m
- •History of chronic pain requiring daily opioids/steroids/clonidine/other α2 agonist/analgesics or any drugs acting on the central nervous system during the previous 2 weeks, and drug/alcohol abuse.
- •Contraindication to the use of local anesthetics.
- •Cardiovascular disease.
- •Severe respiratory, renal or hepatic impairment.
- •Insulin-dependent diabetes mellitus.
- •Central nervous system or psychiatric disease.
Arms & Interventions
Dexmedetomidine group
Patients will receive dexmedetomidine 0.5 μg/kg infusion over 10 min as a loading dose then 0.5 μg/kg/h after induction of anesthesia as maintenance dose till 10 min before the end of the operation plus saline 0.9% with same rate of lidocaine.
Intervention: Dexmedetomidine (Drug)
Lidocaine group
Patients will receive lidocaine 0.3 mg/kg over 10 min loading, 0.3 mg/kg/h infusion after induction of anesthesia as maintenance dose till 10 min before the end of the operation plus saline 0.9% with same rate of dexmedetomidine
Intervention: Lidocaine (Drug)
Lidocaine and Dexmedetomidine group
Patients will receive lidocaine (0.3 mg/kg in 10 min loading, 0.3 mg/kg/h infusion) and dexmedetomidine infusions (0.5 μg/kg infusion over 10 min as a loading dose then 0.5 μg/kg/h) till 10 min before the end of the operation.
Intervention: Lidocaine and Dexmedetomidine (Drug)
Outcomes
Primary Outcomes
Total morphine consumption
Time Frame: 24 hours postoperatively
Rescue analgesia of morphine will be given as 3 mg bolus if the Visual Analogue Scale (VAS)\> 3 to be repeated after 30 min if pain persists until the VAS \< 4.
Secondary Outcomes
- Time of extubation(24 hours postoperatively)
- Time to the first request for the rescue analgesia(24 hours postoperatively)
- Degree of pain(24 hours postoperatively)
- Degree of patient satisfaction(24 hours postoperatively)
- Incidence of adverse events(24 hours postoperatively)
Investigators
Sarah Ahmed
Lecturer of Anesthesia, Intensive care, and pain management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Ain Shams University