Effect of intravenous infusion of magnesium sulfate or lidocaine during anesthesia on postoperative recovery quality in early stage in patients undergoing upper airway surgery

Objective To compare the effect of intravenous infusion of magnesium sulfate and lidocaine during anesthesia on postoperative recovery quality in early stage in patients undergoing upper airway surgery.

Methods A total of 135 patients undergoing elective upper airway surgery were recruited as study objects. The patients were divided into control group, magnesium sulfate group and lidocaine group by random number table method, with 45 cases in each group. During anesthesia, the patients in the magnesium sulfate group were intravenously injected with magnesium sulfate, those in the lidocaine group with lidocaine, and those in the control group with equal volume of normal saline. Quality of Recovery-40 (QoR-40) scores of patients were recorded preoperatively (T₀), 24 h postoperatively (T₁), and 48 h postoperatively (T₂) were observed and compared, intraoperative remifentanil dose, Visual Analogue Scale (VAS) score after extubation, occurrence of rescue analgesia and postoperative nausea as well as vomiting (PONV) were compared.

Results The total scores of QoR-40 and the scores of physical comfort and pain at T₁ and T₂ were significantly higher in the magnesium sulfate group than the control group, the total score of QoR-40, scores of physical comfort, emotional state and pain in the lidocaine group were higher than those in the control group (P < 0.05). At T₁, the score of self-care ability in the lidocaine group was higher than that in the control group(P < 0.05). The total QoR-40 scores at T₁ and T₂ in the lidocaine group were higher than that in the magnesium sulfate group, and the emotional state score at T₁ and physical comfort dimension score at T₂ were higher than those in the magnesium sulfate group (P < 0.05). The amount of remifentanil in the magnesium sulfate group and the lidocaine group during operation was less than that of the control group, and the VAS score after extubation and the incidence of PONV within 48 h after operation were lower than the control group (P < 0.05). The postoperative amount of remifentanil in the lidocaine group was less than that in the magnesium sulfate group (P < 0.05). There was no significant difference in the remedial analgesia rate among the three groups (P>0.05).

Conclusion Intravenous infusion of lidocaine during anesthesia has better efficacy than magnesium sulfate in improving recovery quality in early stage in patients undergoing upper airway surgery.