The Effect of Lidocaine Infusion during General Anesthesia on Neutrophil-Lymphocyte-Ratio in Breast Cancer Patients Candidate for Mastectomy; a Clinical Trial

Introduction: Considering the anti-inflammatory role of intravenous (IV) lidocaine, its analgesic properties, and its ability to reduce the need for opioids during and after surgery, in this study we decided to evaluate the effect of IV lidocaine infusion on levels of inflammatory factors based on neutrophil to lymphocyte ratio (NLR) in breast cancer surgery candidates.Methods: The present study is a randomized clinical trial. All the patients with ASA: I, II breast cancer, who were candidates of mastectomy elective surgery were included. The patients were allocated to 2 groups of IV lidocaine and normal saline based on a random numbers table. After inducing anesthesia similarly for all the patients, using 0.02 mg/kg midazolam, 2-4 µg/kg fentanyl, 1-2 mg/kg propofol and 0.5 mg/kg atracurium, either 1.5 mg/kg/hr IV lidocaine or the same volume of normal saline was infused intravenously. Glasgow prognostic score and NLR were calculated before and 6, 24, and 48 hours and 14 days after surgery.Results: A total of 63 women suffering from breast cancer, with the mean age of 49.25 ± 9.32 years, were included, and allocated to lidocaine and control groups using simple randomization. There was no statistically significant difference between the 2 groups regarding mean age (p = 0.591), incision size (p = 1.000), and duration of surgery (p = 0.752). Using mixture model regression analysis and after adjusting the effect of baseline variables, a significant difference was detected between the groups regarding NLR during the follow-up period (p = 0.006).Conclusion: Based on the findings of the present study, it seems that NLR changes were smaller in breast cancer patients, who had received lidocaine infusion during surgery, compared to the control group.