Postoperative pain and recovery impairment after video-assisted thoracoscopic surgery (VATS)
Conditions
Interventions
Experimental: Intravenous Lidocaine:Patients receive intravenous lidocaine starting at anesthesia induction with a bolus of 1.0 mg/kg (based on ideal body weight
if actual body weight is less than ideal, the actual weight is used), followed by continuous infusion at 1.5 mg/kg/h during surgery. After skin closure, the infusion continues at 1.5 mg/kg/h via an el
Placebo Comparator: Normal Saline (Placebo):Patients receive intravenous lidocaine during surgery using the same bolus and intraoperative infusion protocol as the experimental group. After skin closur
Sponsors
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1.Adults aged 18 to 80 years, male or female. 2.Scheduled for elective video-assisted thoracoscopic surgery (VATS), including lobectomy, segmentectomy, wedge resection, or mediastinal tumor resection. 3.Classified as American Society of Anesthesiologists (ASA) physical status I–III. 4.Provide written informed consent and demonstrate willingness to comply with study procedures and follow-up. 5.Agree to postoperative analgesia using a patient-controlled analgesia (PCA) device.
Exclusion criteria
Exclusion criteria: 1.Previous thoracic surgery, or any other surgical procedure within 1 month prior to enrollment. 2.History of substance abuse, chronic alcohol intake, or long-term opioid use before surgery. 3.Pregnant or breastfeeding women. 4.Severe psychiatric or neurological disorders, including epilepsy, schizophrenia, anxiety disorders, or dementia. 5.History of chronic pain. 6.Known allergy or hypersensitivity to local anesthetics (e.g., lidocaine). 7.Significant hepatic or renal dysfunction, defined as: (1) Serum bilirubin >1.5 × upper limit of normal (ULN); (2) Creatinine clearance 1.25 × ULN; (3) Aspartate aminotransferase (AST), alanine aminotransferase (ALT), or total bilirubin >2.5 × ULN.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of moderate-to-severe movement-evoked pain at 24 hours postoperatively; | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of moderate-to-severe movement-evoked pain at 48 and 72 hours postoperatively;Resting pain intensity over 72 hours;Postoperative opioid consumption;Number of PCA triggers;Incidence of postoperative pulmonary complications (PPCs);Incidence of chronic neuropathic pain;Sleep quality;Health-related quality of life;Incidence of delayed neurocognitive recovery (dNCR).; | — |
Countries
China
Contacts
Public ContactZhang Ni
Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
Outcome results
None listed