Abstract:Objective To analyze the effects of different doses of lidocaine combined with sufentanil on postoperative pain and neuroelectrophysiological parameters in elderly patients undergoing laparoscopic surgery.Methods The medical records of 97 elderly patients undergoing laparoscopic surgery in the Baoji Hospital of Traditional Chinese Medicine from March 2021 to July 2024 were retrospectively analyzed, and they were divided into the high-dose group (n = 50) and the low-dose group (n = 47) by the random number table method. Sufentanil was used for anesthesia induction in both groups. The low-dose group was infused with lidocaine at a loading dose of 1.0 mg/kg for 10 min, followed by a continuous infusion at 1.0 mg/(kg·h) until the end of surgery. The high-dose group was infused with lidocaine at a loading dose of 2.0 mg/kg for 10min, followed by a continuous infusion at 2.0 mg/(kg·h) until the end of surgery. The general conditions, postoperative pain, neuroelectrophysiological parameters, hemodynamics, stress response and adverse reactions were compared between the two groups.Results The total dosage of propofol and the number of effective presses of the patient-controlled analgesia pump in the high-dose group were lower than those in the low-dose group (P < 0.05). There was no significant difference in the operative duration, remifentanil dosage, anesthesia duration, or intraoperative blood loss between the low-dose group and the high-dose group (P > 0.05). The comparison of VAS scores at rest 6 hours, 12 hours, and 48 hours after operation between the two groups showed that they were different among the time points (P < 0.05) and between the groups (P <0.05). The VAS scores in the high-dose group were higher than those in the low-dose group, indicating better analgesic effects. The change trends of VAS scores were also different between the two groups (P <0.05). Comparisons were made between the two groups regarding N20 latency, N20 amplitude, and adductor hallucis latency and amplitude at T0, T1, and T2. Differences in N20 latency and amplitude across different time points were statistically significant (P < 0.05), while differences in adductor hallucis latency and amplitude at different time points were not statistically significant (P > 0.05). Between-group comparisons showed statistically significant differences in N20 latency and amplitude (P < 0.05), whereas no significant differences were observed in adductor hallucis latency and amplitude (P > 0.05). The change trends of N20 latency and amplitude between the two groups were statistically significant (P < 0.05), while those of adductor hallucis latency and amplitude showed no statistically significant differences (P > 0.05). Comparisons of MAP and HR at T0, T1, and T2 were also conducted in the two groups, where they were different across the time points (P < 0.05) but not between the groups (P > 0.05). The change trends of MAP and HR between the two groups also showed no statistically significant differences (P > 0.05). The pre- and postoperative changes in Cor and AngⅡ levels were significantly lower in the high-dose group than in the low-dose group (P < 0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusions Different doses of lidocaine combined with sufentanil can both effectively maintain hemodynamic stability and demonstrate good safety in elderly patients undergoing laparoscopic surgery. Compared with low-dose lidocaine, high-dose lidocaine is superior in reducing postoperative pain and stress responses, whereas it may compromise the quality of neuroelectrophysiological monitoring.
