Effect of Perioperative Intravenous Lidocaine Infusion and Magnesium Infusion on the Functional Recovery After General Anesthesia in the Patients Undergoing Thyroid Surgery
Condition: Thyroid Cancer
MeSH terms: Thyroid Neoplasms; Thyroid Diseases
Study type: Interventional

Summary: 
      Studies have attempted to control pain and increase patients' recovery satisfaction following
      many kinds of operations by using as small an opioid analgesic dose as possible and adding a
      nonopioid analgesic to reduce the side effects of narcotic analgesics. Among nonopioid
      analgesics, lidocaine and magnesium are drawing attention, having been shown to be helpful in
      controlling postoperative pain by lowering pain hypersensitivity to surgical stimuli.
      Lidocaine acts as an antagonist of the N-methyl-D-aspartate (NMDA) receptor. An
      intraoperative intravenous injection of lidocaine has been reported to improve postoperative
      pain control by reducing postoperative pain and opioid consumption. Another report showed
      that an intraoperative intravenous injection of lidocaine improved the quality of
      postoperative functional recovery after general anesthesia in a laparoscopic cholecystectomy
      patient. In addition, a review article on the effect of intraoperative intravenous injection
      of magnesium found it to be an effective analgesic that may be added to conventional
      opioid-based therapy because it generally reduces opioid consumption, decreases pain
      assessment for 24 hours after surgery, and lacks severe side effects in relation to magnesium
      administration. However, there has been insufficient research comparing the intraoperative
      intravenous injection of lidocaine or magnesium in terms of which is more helpful for general
      functional recovery and decreased postoperative pain. Recently, the scope of research on
      anesthesia has come to embrace postanesthetic recovery; to help patients return to daily
      life, the research trend is now shifting from the improvement or resolution of a specific
      symptom to the measurement of general recovery. Postoperative recovery is a complicated
      process related to such catamnestic factors as physiological end-points, the incidence of
      adverse events, and changes in psychological status. A widely used method to measure
      postoperative recovery is the Quality of Recovery 40 (QoR-40) survey. The QoR-40 includes a
      total of 40 questions that may be divided into five sub-categories: emotional state, physical
      comfort, psychological support, physical independence, and pain. The respondent answers each
      question on a 5-point scale, with one being worst and five being best. The QoR-40 takes 6.3
      minutes on average to complete and is known to have good test-retest reliability, internal
      consistency, and split-half reliability. With respect to anesthetic recovery, the QoR-40 has
      been used in various studies to investigate how the surgery type, anesthesia method,
      administration of an additional drug, and gender affect anesthesia and surgery. The validity
      of the QoR-40 for research purposes has already been established.

      Therefore, in this study, we investigated the intraoperative intravenous injection of
      lidocaine and the intravenous injection of magnesium to compare these drugs' helpfulness in
      the functional recovery of thyroidectomy patients after general anesthesia.
    


Intervention name(s): Lidocaine; Magnesium
Intervention type(s): Drug; Drug
Intervention description(s): The administered drugs for each group were prepared by an anesthetist who did not participate in the study according to directions given by the patient in charge of the study. (for Lidocaine Group, 1% lidocaine 40 mL was prepared in a 50 mL syringe; The administered drugs for each group were prepared by an anesthetist who did not participate in the study according to directions given by the patient in charge of the study. (for Magnesium Group, MgSO4 4g 40 mL was prepared in a 50 mL syringe)
Intervention MeSH terms: Lidocaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Keywords: Lidocaine; Magnesium; Functional recovery