Regional anaesthetic block for lung resection surgery: the magic bullet we already use?

Lung resection surgery carries a high risk of postoperative and particularly pulmonary complications partly because of an exaggerated surgical stress response and associated inflammatory dysregulation. Intraoperative lidocaine administered i.v. or via paravertebral catheters reduces the incidence and severity of postoperative complications after minimally invasive lung resection surgery when compared with intraoperative remifentanil infusion. Lidocaine administration was also associated with a reduction in inflammatory biomarkers compared with remifentanil. Uncertainties remain regarding the relative clinical benefits of lidocaine vs other local anaesthetics, the impact of timing and mode of local anaesthetic administration, and the potential harms associated with remifentanil infusion in the absence of regional anaesthesia.