Effect of intravenous lidocaine on postoperative fatigue syndrome in patients undergoing laparoscopic radical colorectal cancer surgery: a randomized clinical trial

To investigate the effect of intravenous lidocaine on postoperative fatigue syndrome (POFS) in laparoscopic radical colorectal cancer surgery patients, a randomized controlled trial enrolled 86 patients aged over 18 with preoperative Christensen score ≤ 4 at Xuzhou Central Hospital from September 2023 to June 2024. The lidocaine group (group L) received an intravenous infusion of 1.5 mg·kg^-1 of lidocaine for 15 min, 30 min prior to anesthetic induction, followed by sustained infusion at 1.5 mg·kg^{- 1}·h^{- 1} until surgical closure. The control group (group C) received an equal volume of normal saline in the same manner. Compared with the group C, the time-weighted average (TWA) of Christensen score in the group L decreased by 0.42 (95% CI, 0.12 ~ 0.73, P < 0.05). Compared with the group C, the VAS at 1,3 and 5 days after surgery in the group L were lower (P < 0.05), the levels of IL-6 and TNF-α immediately after surgery and 24 h after surgery were lower (P < 0.05), and the time to first flatus and defecation was shorter (P < 0.05). No significant differences between the two groups in extubation time, PACU stay duration, incidence of postoperative nausea and vomiting (PONV), or length of postoperative hospital stay (P > 0.05). Results indicate that intravenous lidocaine effectively improved POFS in patients undergoing laparoscopic radical resection of colorectal cancer, which might be achieved by inhibiting the postoperative inflammatory response and reducing postoperative pain.