Abstract
Background and Objective:
This randomized controlled trial investigated the influence of perioperative lidocaine administration on the postoperative inflammatory response in patients undergoing robot-assisted laparoscopic radical prostatectomy, with the results having potential implications for postoperative recovery and cancer recurrence via neutrophil extracellular trapping (NETosis).
Methods
In total, 58 patients with localized prostate cancer were randomly assigned to receive an intravenous infusion of 2% lidocaine or a saline placebo intraoperatively. Serum levels of interleukin (IL)-6, IL-10, IL-17, tumor necrosis factor(TNF)-α, interferon(IFN)-γ, neutrophil elastase (NE), citrullinated histone3 (CitH3), and myeloperoxidase (MPO) were determined preoperatively and at 24 h postoperatively. Biochemical recurrence (BCR) was assessed over a follow-up period of 2 years.
Results
The lidocaine group showed a significantly greater reduction in IL-10 level and a smaller increase in the NE level compared to the placebo group, suggesting a modulatory effect of lidocaine on certain anti-inflammatory and neuroendocrine pathways. Changes in other cytokines and markers were not significantly different between the groups. No significant difference in the BCR rate was observed between the two groups.
Conclusion
Perioperative lidocaine administration selectively modulates certain inflammatory and neuroendocrine responses after prostate cancer surgery, potentially influencing recovery outcomes. These findings highlight the need for further investigations of the role of lidocaine in Enhanced Recovery After Surgery protocols, particularly in oncologic surgeries. However, large-scale studies with diverse populations are needed to verify our findings and understand the influence of lidocaine administration on long-term cancer outcomes.