The effect of perioperative intravenous lidocaine infusion on postoperative sleep of elderly patients with colorectal cancer

Abstract Background: Postoperative sleep disturbance (POSD) in patients with colorectal cancer is a key factor affecting their rapid postoperative recovery. Studies have confirmed that perioperative use of opioids can disturb postoperative sleep, and perioperative oligoopioids or no opioid in elderly patients can promote postoperative recovery. To reduce the use of opioids, this study was to investigate the effect of perioperative intravenous lidocaine analgesia on the postoperative sleep of elderly patients undergoing laparoscopic radical resection for colorectal cancer. Methods 63 patients aged 65-80 years with body mass index (BMI) values of 20-30 kg/m2 and American society of anesthesiologists (ASA) grades of II-III, who underwent elective laparoscopic radical resection for colorectal cancer, were selected. The patients were divided into the lidocaine group (group L, n = 32) and the control group (group C, n = 31) by using a random number table. Patients in both groups received total intravenous anesthesia. In group L, a dose of 1.5 mg/kg of lidocaine was injected intravenously during induction of anesthesia, and lidocaine (1.0 mg·kg-1·h-1) was injected intravenously during surgery and for 24 hours after surgery. In Group C, the same volume of normal saline was injected, and intravenous patient-controlled analgesia (Sufentanil 1.5-1.8 μg/kg) was given after surgery. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep function 1 d before surgery, 1 d, 2 d, and 3 d after surgery. The incidence of postoperative sleep disturbance (POSD) at 1 d, 2 d and 3 d after surgery was calculated. The pain intensity of the two groups at different time points after surgery was evaluated. The intraoperative consumption of opioids and propofol and the incidence of postoperative complications and lidocaine adverse reactions in 2 groups were recorded. Results Compared with group C, sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, daytime dysfunction scores, and total PSQI score was improved significantly in group L at 1 d, 2 d, and 3 d after surgery (P <0.05). Compared with group C, the incidence of POSD in group L was lower, and the difference was statistically significant (P <0.05). There was no significant difference in postoperative pain intensity between the two groups (P > 0.05) Compared with group C, the consumption of opioids and propofol in group L decreased significantly (P <0.05). There was no statistically significant difference in the incidence of postoperative complications. No patient in group L had side effects of lidocaine. Conclusions For elderly patients undergoing laparoscopic radical resection of colorectal cancer, perioperative intravenous lidocaine infusion can improve the early postoperative sleep quality, reduce the incidence of postoperative sleep disturbance, and promote the recovery of postoperative sleep function.