Objective To investigate whether continuous intravenous intraoperative lidocaine infusion can reduce the opioids dosage and improve postoperative recovery in patients undergoing video-assisted thoracoscopic(VATS) lobectomy. Methods Totally 60 patients undergoing VATS lobectomy were enrolled in this single-center randomized controlled study.The patients were equally randomized into lidocaine continuous pumping group(lidocaine group) and control group by computer-based random numbers.The patients had double-lumen catheter intubation,and total intravenous anesthesia was administrated intraoperatively.In the lidocaine group,patients continuously received intravenous pumping of lidocaine [2 mg/(kgdh) ] after a loading doses(1 mg/kg) until the end of the operation.We recorded the basic characteristics,preoperative examination,intraoperative medications,and postoperative recovery of both groups.Results The basic characteristics and preoperative examination findings were comparable between these two groups(all P>0.05).Compared with the control group,the intraoperative sufentanil consumption significantly decreased in the lidocaine group [(32.3±7.5) μg vs.(40.9±10.2) μg,P<0.001].Significantly more patients were given esmolol intraoperatively in the control group to lower heart rate(P=0.010).The incidence of postoperative nausea within 24 hours was significantly lower in the lidocaine group(P=0.045).There was no significant difference between the two groups in postoperative recovery(all P>0.05).Conclusion Intravenous continuous pumping of lidocaine during operation can reduce opioids consumption and lower the incidence of postoperative nausea without extra adverse or toxic reaction in patients undergoing VATS lobectomy.