目的 探究静脉注射利多卡因对腹腔镜胃癌根治术患者术后疲劳综合征（postoperative fatigue syndrome， POFS）的影响。 方法 选择2023年9月至2024年6月于徐州市中心医院择期行腹腔镜胃癌根治术患者共80例。年龄18 ~ 75岁，ASAⅠ~Ⅲ级，体质量指数18.5 ~ 27.9 kg/m²，术前1天Christensen疲劳评分≤ 4分，手术时间≤ 4 h。使用随机数字表法将患者随机分配到利多卡因组（L组）和生理盐水组（C组），每组各40例。L组于麻醉诱导前30 min静脉输注利多卡因1.5 mg/kg，持续15 min，并在未观察到不良反应的情况下，术中以1.5 mg/（kg·h）的速度输注至手术结束，C组以同样的方式输注等量的生理盐水。记录患者术后1、3、5、7 d的Christensen疲劳评分和疼痛视觉模拟量表（VAS）评分，并计算疲劳评分的时间加权平均值（time-weighted average，TWA）。检测术后炎症因子水平，记录拔管时间、PACU停留时间、术后恶心呕吐发生比例、术后补救性镇痛药物消耗量、术后首次排气、排便时间以及术后住院时间。 结果 与C组比较，L组患者术后疲劳评分TWA降低了0.44分（95% CI：0.11 ~ 0.76， P < 0.05），术后1、3 d的VAS评分明显降低（P <0.05），术毕即刻、术后24 h的IL-6和TNF-α水平降低（P <0.05），术后首次排气、排便时间明显缩短（P <0.05）。两组患者拔管时间、PACU停留时间、术后恶心呕吐发生比例、术后补救性镇痛药物消耗量、术后住院时间的差异均无统计学意义（P >0.05）。 结论 静脉注射利多卡因可能通过抑制术后炎症反应、减轻疼痛并促进胃肠功能恢复，改善腹腔镜胃癌根治术患者的POFS，且具有良好的安全性。

Objective To investigate the effect of intravenous lidocaine on postoperative fatigue syndrome （POFS） in patients undergoing laparoscopic resection for gastric carcinoma. Methods A total of 80 patients who underwent elective laparoscopic resection for gastric carcinoma at Xuzhou Central Hospital between September 2023 and June 2024 were enrolled. Inclusion criteria included age 18 ~ 75 years， ASA physical status classification Ⅰ~Ⅲ， body mass index （BMI） of 18.5 ~ 27.9 kg/m2， preoperative Christensen score ≤4， and estimated operation time ≤ 4 hours. Patients were randomly allocated into either the lidocaine group （Group L） or the saline group （Group C） using a random number table， with 40 patients in each group. Group L received an intravenous infusion of lidocaine at a dose of 1.5 mg·kg?1 over 15 minutes， initiated 30 minutes before anesthesia induction. If no adverse reactions occurred， lidocaine was maintained at a rate of 1.5 mg/（kg·h） throughout the surgery until its conclusion. Group C received an equivalent volume of normal saline administered in the same manner. The Christensen score and Visual Analogue Scale （VAS） scores were recorded on postoperative days 1， 3， 5， and 7， and the time-weighted average （TWA） of the Christensen score was calculated. Postoperative inflammatory markers were measured， and additional outcomes including extubation time， post-anesthesia care unit （PACU） stay duration， postoperative nausea and vomiting （PONV）， consumption of rescue analgesics， time to first flatus and defecation， and length of hospital stay were also documented. Results Compared with Group C， the TWA of the Christensen score in Group L decreased by 0.44 points （95% CI： 0.11 ~ 0.76； P < 0.05）. The VAS scores were significantly lower in Group L on postoperative days 1 and 3 （P < 0.05）. Levels of IL-6 and TNF-α at the end of surgery and 24 hours after surgery were also lower in Group L （P < 0.05）. The time to first flatus and defecation was significantly shorter in Group L （P < 0.05）. There were no significant differences between the two groups regarding extubation time， PACU stay duration， incidence of PONV， postoperative consumption of remedial analgesic drugs， or length of hospital stay （P > 0.05）. Conclusion Intravenous lidocaine may improve POFS in patients following laparoscopic resection for gastric carcinoma by attenuating inflammatory responses， alleviating pain， and facilitating gastrointestinal function recovery， while maintaining a favorable safety profile.