Discussion
nausea, sleep disturbance, pain, cough, postoperative sleep disturbance, PONV
The current study neither observed significantly impaired sleep quality of patients following thyroid surgery nor demonstrated the effect of intraoperative lidocaine infusion on postoperative sleep quality in patients undergoing thyroidectomy, but it was associated with a significant reduction in the severity of cough within 5 min after extubation, and the incidence of PONV.Postoperative sleep disturbance remains a challenging problem in surgical procedures. Wang et al. [However, our study didn’t show significantly impaired sleep quality of patients in the entire 30 days follow-up period compared with baseline values. On the other hand, we didn’t observe the effect of systemic lidocaine infusion on postoperative sleep quality in patients following thyroidectomy.Previous studies indicated that postoperative sleep disturbance could be related to the magnitude and duration of the operation [Lidocaine was injected at least 20 min before surgical excision, and was infused continuously until a few hours after surgery in those studies which have demonstrated the significant anti-inflammatory properties of lidocaine [Previous studies have indicated that systemic lidocaine may reduce cough, pain and nausea after surgery [There were some limitations associated with this study. Firstly, we didn’t evaluate the precise concentration of lidocaine in the plasma. However, the optimal plasma concentration for lidocaine administered intravenously remains unclear, we used a typical dosage and infusion velocity and relatively short infusion duration compared to other studies. Similar to previous studies, in this study, we did not observe any side effects related to lidocaine administration. Secondary, we didn’t take into consideration possible time- and dose-dependent effects of lidocaine. Thirdly, the patient’s vital signs intraoperatively were not collected, but we monitored them closely at all times. Fourthly, our study demonstrated that intraoperative lidocaine infusion might reduce the severity of cough within 5 min after extubation, as well as the incidence of PONV. However, we didn’t verify the power of analysis on these results, which should be considered with caution. Finally, in this study, we only relied on PSQI questionnaire to evaluate the subjective sleep quality of patients before surgery, 7 days and 30 days after surgery.