Reply to ‘Determining postoperative benefits of intravenous lidocaine and esketamine following thyroidectomy’

Dear Editor, We appreciate the authors’[1] interest and questions about our article,[2] and we would like to respond to the concerns raised. The postoperative analgesic strategy used in the study was administering intravenous tramadol if the patient’s numerical rating scale (NRS) score was greater than 5. Based on the results of our study, none of the patients had a postoperative NRS greater than 5, and the postoperative tramadol doses were not counted, thus eliminating the imbalance in postoperative pain control that the authors claim skews the quality of recovery outcomes in favour of patients who received intravenous lidocaine and esketamine. At the same time, we favour multimodal analgesia. Every patient who returns to the ward is routinely given ketorolac tromethamine by the surgeon. In addition, we did not count the indicator of the proportion of patients who met the diagnostic criteria for anxiety and depression in the three groups. It has been reported that the thresholds of 55 for Self-Rating Depression Scale and 50 for Self-Rating Anxiety Scale are more sensitive and accurate, but there are still undiagnosed and false-positive results.[3] Therefore, we preferred to compare patients’ levels of anxiety and depression rather than meet the diagnostic criteria. Finally, the main aim of this study was to observe changes in the quality of postoperative recovery and the emotional state of thyroidectomy patients. Our original study observed other indicators related to postoperative recovery, such as patients’ sleep quality, length of hospital stay, etc., which are not discussed in the text as they were not the main outcomes. Postoperative rehabilitation evaluation is a multifaceted process, and the quality of the recovery-40 scale and other identified indications in this study may be used to assess several elements of postoperative rehabilitation.[4] Consequently, the addition of intravenous lidocaine and esketamine to general anaesthesia schemes for thyroidectomy may really benefit patients by improving postoperative recovery and clinical outcomes. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.