Closure of defects in a geometric figure pattern associated with tumescent anesthesia with lidocaine in rabbits (Oryctolagus cuniculus)

Abstract The use of tumescent anesthesia with lidocaine can provide better intra- and postoperative analgesia that would benefit extensive reconstructive surgery. However, lidocaine can interfere with the healing process. Therefore, this study aimed to assess the local interference of the healing of induced and closed skin defects in a geometric pattern associated with the use of tumescent anesthesia with lidocaine in rabbits. Furthermore, we assessed its influence on cardiorespiratory parameters and postoperative analgesia. This study included 27 rabbits divided into three groups: GC (without the use of tumescence), GS (use of tumescence with 0.9% NaCl solution), and GL (use of tumescent anesthesia with lidocaine). There was no statistically significant intergroup difference in any stage of the wound healing process on macroscopic evaluations, in the angiogenesis process, or in the process of collagenization and fibroblast deposition. There were significant differences in heart rate (lower in GL), respiratory rate (higher in GC), mean arterial pressure (higher in GL), and expired concentration of isoflurane (lower in GL). There was no significant intergroup difference in the von Frey filament test or the visual analog scale score used to evaluate postoperative analgesia. We concluded that tumescent anesthesia with lidocaine does not impair postoperative tissue repair. Its use features benefits such as reducing the volume of inhaled anesthetic, maintaining the anesthesia plan, stable heart and respiratory rates, and lower hypotension during the surgical procedure.摘要 采用利多卡因（lidocaine）实施肿胀麻醉（tumescent anesthesia）可提供更优的术中及术后镇痛效果，有益于大面积重建手术。然而，利多卡因可能会干扰组织愈合过程。因此，本研究旨在评估利多卡因肿胀麻醉对家兔几何构型诱导性闭合皮肤缺损愈合的局部影响，同时考察其对心肺参数及术后镇痛的作用。本研究共纳入27只家兔，分为三组：GC组（不实施肿胀麻醉）、GS组（采用0.9%氯化钠溶液行肿胀麻醉）及GL组（采用利多卡因行肿胀麻醉）。宏观评估结果显示，三组家兔在伤口愈合各阶段、血管生成过程、胶原沉积及成纤维细胞沉积方面均无统计学意义的组间差异。心率（GL组更低）、呼吸频率（GC组更高）、平均动脉压（GL组更高）及异氟烷呼出浓度（GL组更低）存在显著组间差异。用于评估术后镇痛的冯·弗雷细丝试验及视觉模拟评分法（VAS）评分无显著组间差异。本研究结论表明，利多卡因肿胀麻醉不会损害术后组织修复。其应用优势包括减少吸入麻醉药用量、维持麻醉方案稳定、心率及呼吸频率平稳，以及降低手术过程中低血压的发生风险。