Abstract:Objective To investigate the effect of ketorolac tromethamine combined with lidocaine on the mean arterial pressure (MAP), heart rate, 24-hour postoperative drainage volume, and Visual Analogue Scale (VAS) score for sore throat during the peri-extubation period in hypertensive patients undergoing thyroid surgery. Methods A total of 80 hypertensive patients scheduled for elective thyroid surgery at People's Hospital of Xinjiang Uygur Autonomous Region from December 2020 to March 2023 were randomly selected and divided into four groups: A, B, C, and D. Group A received 1 mL of normal saline before tumor resection and 10 mL of normal saline at the end of the surgery. Group B received 30 mg of ketorolac tromethamine in 1 mL before tumor resection and 10 mL of normal saline at the end of the surgery. Group C received 1 mL of normal saline before tumor resection and 1.5 mg/kg of lidocaine diluted to 10 mL at the end of the surgery. Group D received 30 mg of ketorolac tromethamine in 1 mL before tumor resection and 1.5 mg/kg of lidocaine diluted to 10 mL at the end of the surgery. All medications were administered as a single intravenous injection. MAP and heart rate were recorded before anesthesia induction, at extubation, 5 minutes after extubation, and 15 minutes after extubation. Coughing scores at extubation, postoperative adverse reactions, 24-hour postoperative drainage volume, and VAS scores for sore throat were also recorded. Results There was a significant difference in coughing scores at extubation among the four groups (H=31.658, P<0.01). The MAP and heart rates at 5 and 15 minutes after extubation in Groups B, C and D were lower than those in Group A (P<0.05). The VAS scores for sore throat 24 hours after extubation were 1.95±0.69 in Group A, 0.90±0.64 in Group B, 2.25±0.79 in Group C, and 0.75±0.64 in Group D, with a significant difference among the four groups (F=23.508, P<0.01). The VAS scores in Groups B and D were significantly lower than those in Groups A and C, respectively (P<0.05). There was a statistically significant difference in 24-hour postoperative drainage volume among the four groups (F=204.309, P<0.01). There was no statistically significant difference in the incidence of other adverse reactions after extubation among the four groups (P>0.05). Conclusion Intravenous administration of lidocaine combined with ketorolac tromethamine in hypertensive patients undergoing thyroid surgery can effectively reduce adverse reactions such as sore throat and coughing during the peri- extubation period while maintaining stable MAP and heart rate.