Effect of lidocaine combined with dexmedetomidine on the recovery period of patients undergoing supratentorial tumor resection

Objective To investigate the effect of lidocaine combined with dexmedetomidine on the recovery period and brain injury of patients undergoing supratentorial tumor resection.Methods A total of 76 patients who were scheduled for supratentorial tumor resection under combined intravenous-general anesthesia in the Affiliated Hospital of Xuzhou Medical University from March 2021 to September 2022 were selected. According to the random number table method, the patients were divided into four groups:a control (Con) group, a lidocaine (Lido) group, a dexmedetomidine (DEX) group and a lidocaine plus dexmedetomidine (Lido+DEX) group. All the patients received the same basic anesthetics, and were continuously infused with the corresponding drugs until the end of the operation. Then, the hemodynamics, agitation and coughing were measured 10 min after entering into the room (T0), at post-anesthesia 1 h (T1), at the withdrawal of the tube (T2), and 3 min after withdrawal of the tube. Meanwhile, the levels of neuron-specific enolase (NSE) and S-100β protein were detected to evaluate the brain injury.Results There was no statistical difference in heart rate (HR) and mean arterial pressure (MAP) among the four groups (P>0.05). At T2, compared with the Con group, the DEX, and Lido+DEX groups showed significant decreases in HR and MAP. At T2, there was statistical difference in MAP between the Lido+DEX and Lido groups (P<0.05). Compared with the Con group, the Lido+DEX group had significantly higher rates of non-coughing and agitation during the recovery period, and there was statistical difference in the rate of non-coughing between the Lido+DEX group and the Lido and DEX groups(P<0.05). At T0, the levels of NSE and S-100β in each group were not statistically different (P>0.05). At T3, compared with the Con group, the levels of NSE were significantly reduced in the DEX group and Lido+DEX group; while the levels of S-100β in the Lido, DEX, and Lido+DEX groups remarkably decreased. Furthermore, compared with the Lido group, the Lido+DEX group showed statistical decreases in NSE levels (P<0.05); compared with the DEX group, the Lido+DEX group showed statistical decreases in S-100β levels (P<0.05).Conclusions Lidocaine combined with dexmedetomidine can significantly maintain the hemodynamic stability of patients during the recovery period and reduce the occurrence of coughing and agitation, in order to attenuate the brain injury in patients with supratentorial tumor resection.