Abstract
Background: After functional endoscopic nasal surgery, emergence agitation is not uncommon. The aim of this trial was to investigate the effect of perioperative lidocaine infusion on postoperative early recovery quality and incidence of emergence agitation in patient undergoing functional endoscopic sinus surgery. Study Design: Prospective, randomized, double-blinded, placebo-controlled trial. Methods: 100 patients of ASA I and II, aged 18 - 50 years, of both sexes scheduled for FEES, were assigned into two groups. In Group L; patients received an intravenous bolus infusion of 1.5 mg/kg lidocaine just before induction of anesthesia followed by a continuous infusion of 2 mg/kg/h during the operation and until the end of the surgery. In Group C; patients received normal saline infusion with the same volume as group L according to the same protocol. The primary endpoints were incidence of emergence agitation and postoperative recovery quality (QoR-40) score on first postoperative day (POD1). Results: Incidence of emergence agitation was significantly lower in group L (P 0.05) compared with group C. Global QoR-40 scores on POD1 were significantly lower in both groups compared with preoperative assessment, it was significantly higher in group L on POD1 (P 0.05) than in group C. Among the five dimensions of QoR-40, the scores for physical comfort and pain were superior in group L compared to group C (P 0.05) at POD1. Conclusion: Systemic lidocaine infusion can improve QoR-40 scores and decrease incidence of emergence agitation in patients scheduled for FEES, also it reduces the duration of stay in PACU after surgery.
Highlights
Functional endoscopic sinus surgery (FEES) is a common surgical procedure in the otorhinolaryngology specialty for symptomatic improvement in patients with medically refractory chronic rhinosinusitis and chronic polypous rhinosinusitis [1].The essential anesthesia requirements for FESS include airway management, considerations for facilitating surgical access, provision of a clear and still surgical field for precision surgery, assuring quick and non-stimulating emergence from anesthesia, and fast-tracking patients for discharge [2].Postoperative recovery which is defined as the patients return to the normal state after a surgery is the key outcome in the perspective of anesthesiologists
Systemic lidocaine infusion can improve quality of recovery (QoR)-40 scores and decrease incidence of emergence agitation in patients scheduled for FEES, it reduces the duration of stay in postoperative care unit (PACU) after surgery
The main objective of the current study was to evaluate the effect of systemic continuous lidocaine infusion in patients undergoing FESS procedure as regards to quality of postoperative recovery, emergence agitation incidence and time to discharge from postoperative care unit (PACU)
Summary
Postoperative recovery which is defined as the patients return to the normal state after a surgery is the key outcome in the perspective of anesthesiologists In the past it has been referred in terms of pain scores, duration of hospital stay, and return to normal activities [3]. It involves several factors such as regain of physical, physiologic and social functions. Conclusion: Systemic lidocaine infusion can improve QoR-40 scores and decrease incidence of emergence agitation in patients scheduled for FEES, it reduces the duration of stay in PACU after surgery
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