Key result
Lidocaine combined with dexmedetomidine significantly reduced the incidence of postoperative nausea and vomiting compared to lidocaine alone (28.0% vs 58.0%) in patients undergoing laparoscopic hysterectomy.
Why the study?
The study was conducted to investigate the anesthetic effect and safety issues of combining lidocaine with dexmedetomidine in laparoscopic hysterectomy.
Does the combination of dexmedetomidine and lidocaine improve hemodynamics, analgesia, and stress response compared to lidocaine alone in patients undergoing laparoscopic hysterectomy?
RCT (n=100)
randomly but equally divided
No
Does the combination of dexmedetomidine and lidocaine improve hemodynamics, analgesia, and stress response compared to lidocaine alone in patients undergoing laparoscopic hysterectomy?
Absolute Event Rate: 28% vs 58%
p-value: p=0.002
Combining dexmedetomidine with lidocaine during laparoscopic hysterectomy improves postoperative analgesia and hemodynamics while reducing inflammatory stress and postoperative nausea and vomiting.
Supports dexmedetomidine-lidocaine combination to lower PONV after laparoscopic hysterectomy; extends multimodal perioperative evidence to antiemetic outcomes.
Purpose: To investigate the anesthetic effect and safety issues when lidocaine is combined with dexmedetomidine in laparoscopic hysterectomy. Methods: The data for 100 patients from the Anesthesiology Department of Changzhou Second People's Hospital Affiliated to Nanjing Medical University who underwent laparoscopic total hysterectomy were randomly but equally divided into a control group and a combination group. Lidocaine hydrochloride was administered by infusion in the control group, while dexmedetomidine and lidocaine were administered together in the combination group. Inflammatory factors and stress hormone levels before and after the operation, as well as the incidence of adverse reactions following the operation, hemodynamic index, visual pain simulation (VAS) score, and sedation score at various times after the operation were evaluated in the two groups. Furthermore, the incidence of postoperative adverse reactions were also recorded and compared between the two groups. Results: The combination group's recovery time was significantly longer than that of the control group (p < 0.05). At the point of extubation and 10 min after, mean arterial pressure (MAP) and heart rate (HR) in the combination group were significantly lower than those of the control group, respectively (p < 0.05), while the combination group's VAS and Ramsay scores were statistically lower than those of the control group at 30 min, 24 h, and 48 h following surgery, respectively (p < 0.05). The incidence of nausea and vomiting in the combination group was significantly lower than that in the control group (28.0% vs 58.0%, p < 0.05). Conclusion: Lidocaine and dexmedetomidine, when combined, enhance hemodynamics, postoperative analgesia, and sedation in laparoscopic hysterectomy patients. The combination also lowers inflammatory stress and stress hormone levels, as well as the risk of nausea and vomiting, leading to better safety in the patients. However, multicenter trials are recommended to validate these findings prior to its use clinical practice.
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Zhang et al. (2024) conducted an RCT in Uterine fibroids or adenomyosis (n=100). Lidocaine combined with dexmedetomidine vs. Lidocaine 1.5 mg/kg loading then 1.5 mg/kg/h was evaluated on Incidence of nausea and vomiting (p=0.002). Lidocaine combined with dexmedetomidine significantly reduced the incidence of postoperative nausea and vomiting compared to lidocaine alone (28.0% vs 58.0%) in patients undergoing laparoscopic hysterectomy.
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