Observation on the effect of intravenous infusion of low-dose lidocaine in improving rebound pain after brachial plexus block

LI Jiaying; ZHAO Yajie; ZHAI Ruirui; ZHOU Maitao

doi:10.3969/j.issn.1674-3806.2024.10.09

Abstract：Objective To observe the effect of intravenous infusion of low-dose lidocaine in improving rebound pain after brachial plexus block.Methods A total of 80 patients with unilateral upper limb fracture who underwent elective open reduction and internal fixation under brachial plexus block anesthesia were recruited in the 904th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from July 2023 to November 2023.The patients were divided into the control group(after successful brachial plexus block,receiving intravenous infusion of normal saline)and the observation group(after successful brachial plexus block,receiving intravenous infusion of lidocaine at a dose of 100 mg)by using random number table method,with 40 cases in each group.In the control group,there was 1 case of incomplete block and 1 case was lost to follow up after operation.In the observation group,there was 1 case of incomplete block.After the patients with incomplete block and loss to follow up after operation were excluded,38 cases were included in the control group and 39 cases in the observation group finally.The occurrence and duration of rebound pain,drug consumption of the analgesic pump,time of sensory block,rate of remedial analgesics and adverse reactions were compared between the two groups within 48 hours of nerve block.The Numerical Rating Scale(NRS)scores of resting state and activity state were compared between the two groups at different time points before and after surgery.Results Compared with the control group,the observation group had lower incidence of rebound pain(17.95％vs 39.47％),less drug consumption of the analgesic pump[(105.62±11.21)mL vs(114.29±15.45)mL],and the differences were statistically significant(P＜0.05).There was no significant difference in the time of sensory block between the two groups(P＞0.05).Among the patients with rebound pain,the duration of rebound pain in the observation group was shorter than that in the control group,and the difference was statistically significant[(2.43±1.27)h vs(3.87±1.19)h;t=2.589,P=0.018].Compared with the control group,the observation group had lower NRS scores of resting state 12 hours and 24 hours after nerve block,and lower NRS scores of activity state 12 hours after nerve block,and the differences were statistically significant(P＜0.05),and there were no statistically significant differences in NRS scores between the two groups at the other time points(P＞0.05).The rate of remedial analgesics within 48 hours after operation in the observation group was significantly lower than that in the control group(P＜0.05),and there were no significant differences in the incidence rate of nausea and vomiting and the incidence rate of dizziness between the two groups(P＞0.05).Conclusion Intravenous infusion of low-dose lidocaine can reduce the incidence rate and duration of rebound pain after brachial plexus block,reduce drug consumption of the analgesic pump and rate of remedial analgesics after operation,with fewer adverse reactions,which is conducive to rapid recovery of the patients.