{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T22:23:02Z","timestamp":1783981382091,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background: The perioperative period in cancer surgery is characterized by transient metabolic and inflammatory perturbations that may influence early postoperative biochemical dynamics. Surgical stress induces insulin resistance, hyperglycemia, cytokine activation, and metabolic shifts that interact with tumor cell signaling pathways. Intravenous lidocaine has been associated with anti-inflammatory and systemic stabilizing effects beyond analgesia. We investigated whether perioperative lidocaine administration during robotic-assisted radical prostatectomy (RARP) is associated with early postoperative prostate-specific antigen (PSA) dynamics within the context of perioperative metabolic\u2013inflammatory modulation. Methods: In this single-center retrospective cohort study, 180 patients undergoing RARP for localized or locally advanced prostate cancer were stratified according to perioperative intravenous lidocaine exposure. The primary endpoint was undetectable PSA (&lt;0.1 ng\/mL) at 6\u201312 weeks postoperatively. Secondary endpoints included PSA detectability at 3 and 6 months and time to first detectable PSA. Multivariable logistic and Cox regression models were adjusted for established oncologic risk factors. Perioperative glycemic variation, intraoperative lactate dynamics, and postoperative IL-6 levels were analyzed as indicators of stress-induced metabolic activation. Results: Lidocaine exposure was independently associated with higher odds of undetectable PSA at 6\u201312 weeks (OR 2.10, 95% CI 1.15\u20133.85) and at subsequent time points. In Cox analysis, lidocaine was associated with a reduced hazard of PSA detectability (HR 0.58, 95% CI 0.37\u20130.92). Patients receiving lidocaine demonstrated significantly attenuated perioperative hyperglycemia, lower lactate elevation, and reduced IL-6 response. Conclusions: Perioperative intravenous lidocaine administration during RARP was associated with more favorable early PSA dynamics and attenuation of perioperative metabolic\u2013inflammatory activation. Given the retrospective and non-randomized design of the study, these findings should be interpreted as associative and hypothesis-generating, and warrant confirmation in prospective controlled investigations.<\/jats:p>","DOI":"10.3390\/metabo16030209","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:02:43Z","timestamp":1774026163000},"page":"209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Perioperative Intravenous Lidocaine and Early Biochemical Outcomes After Robotic-Assisted Radical Prostatectomy: A Clinical Study Within the Framework of Perioperative Metabolic-Inflammatory Modulation"],"prefix":"10.3390","volume":"16","author":[{"given":"Georgiana Maria","family":"Popa","sequence":"first","affiliation":[{"name":"Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania"},{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6793-5361","authenticated-orcid":false,"given":"Simona-Alina","family":"Abu-Awwad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Clinic of Obstetrics and Gynecology, \u201cPius Brinzeu\u201d County Clinical Emergency Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6185-0960","authenticated-orcid":false,"given":"Ahmed","family":"Abu-Awwad","sequence":"additional","affiliation":[{"name":"Department XV\u2014Discipline of Orthopedics\u2014Traumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Clinic of Orthopedics, \u201cPius Brinzeu\u201d County Clinical Emergency Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3574-6964","authenticated-orcid":false,"given":"Nicolae Ovidiu","family":"Pop","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parascovia","family":"Pop","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Ioana","family":"Marta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Clinic of Obstetrics and Gynecology, \u201cPius Brinzeu\u201d County Clinical Emergency Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca Mihaela","family":"Bina","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Clinic of Obstetrics and Gynecology, \u201cPius Brinzeu\u201d County Clinical Emergency Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7844-1111","authenticated-orcid":false,"given":"Erika Bimbo","family":"Szuhai","sequence":"additional","affiliation":[{"name":"Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania"},{"name":"Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Cacuci","sequence":"additional","affiliation":[{"name":"Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania"},{"name":"Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian Gheorghe","family":"Osiceanu","sequence":"additional","affiliation":[{"name":"Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciprian Dumitru","family":"Puscas","sequence":"additional","affiliation":[{"name":"Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodor Traian","family":"Maghiar","sequence":"additional","affiliation":[{"name":"Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3390-2812","authenticated-orcid":false,"given":"Mihai Octavian","family":"Botea","sequence":"additional","affiliation":[{"name":"Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania"},{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kimura, S., Urabe, F., Sasaki, H., Kimura, T., Miki, K., and Egawa, S. 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