Comparison of intravenous and intraperitoneal lignocaine for pain relief following laparoscopic cholecystectomy: a double-blind, randomized, clinical trial

Ram, Duvuru; Sistla, Sarath Chandra; Karthikeyan, Vilvapathy Senguttuvan; Ali, Sheik Manwar; Badhe, Ashok Shankar; Thulasingam, Mahalakshmy

doi:10.1007/s00464-013-3325-5

Cited by 16 publications

(11 citation statements)

References 14 publications

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“…At 6 hours after the end of the procedure, the average resting VAS pain score was marginally lower for the lidocaine group ( [4][5][6][7][8][9][10], p = .64) pain scores were slightly higher for the lidocaine group than the placebo group; however, none of the differences in pain scores between the two groups was statistically significant (see Figure 2). There was no difference in the overall change in VAS resting scores (p = .347), VAS coughing scores (p = .606), or VAS mobile scores (p = .626) between groups.…”

Section: Postoperative Pain and Opioid Consumptionmentioning

confidence: 70%

“…[2] A number of drugs and techniques have been used in an attempt to decrease postoperative pain while minimizing opioid use, including ketorolac, dexmedetomidine, ketamine, peripheral nerve blocks, neuraxial blocks, continuous delivery of local anesthetic using an infusion pump system, and intraperitoneal infusions, with varying results. [3][4][5][6][7][8] Still, there is limited literature on signs and symptoms associated with local anesthetic toxicity, especially in obese patients.…”

Section: Introductionmentioning

confidence: 99%

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Systemic intraoperative lidocaine infusion for postoperative pain management in obese patients: A randomized, placebo controlled pilot study

Alvey

Ching

Karlnoski

et al. 2016

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Background: Systemic intraoperative lidocaine has been seen to decrease postoperative pain following abdominal surgery, but few studies have examined its use in morbidly obese patients. Objective: We sought to evaluate the safety and effects of intravenous lidocaine in obese patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) surgery. Methods: Setting: University-affiliated, private hospital, United States. In this preliminary prospective, double-blinded, and placebo-controlled safety study, we enrolled 21 patients and 20 completed the study. Ten patients were randomly assigned to the study group and received a continuous infusion of lidocaine intravenously from induction of general anesthesia until the end of the operation. Ten other patients were assigned to the control group and received a dextrose placebo intravenously over the same time period. Subjects were followed for 24 hours postoperatively. The primary endpoint was the presence of symptoms of lidocaine toxicity at 1 hour postoperatively. Exploratory outcomes were adverse events, visual analog scale (VAS) pain scores, opioid consumption, time to first passage of flatus and bowel movement, and length of hospital stay. Results: No significant differences were seen between groups for overt signs of lidocaine toxicity or adverse events, opioid consumption, postoperative pain scores, time to first passage of flatus or first bowel movement, or length of hospital. We identified a trend towards less opioid consumption in patients receiving lidocaine. We were underpowered to detect statistical differences due to our pilot study design; addressing safety as the primary outcome measure as opposed to efficacy. Conclusions: In this study, intravenous lidocaine in RYGB surgery was found to be safe without differences in postoperative pain or adverse effects.

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Section: Postoperative Pain and Opioid Consumptionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Systemic intraoperative lidocaine infusion for postoperative pain management in obese patients: A randomized, placebo controlled pilot study

Alvey

Ching

Karlnoski

et al. 2016

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“…In the following studies [7], [13], [14], [15] that record the effect of intraperitoneal lidocaine or pulmonary recruitment in abdominal pain after laparoscopic surgeries, the patients had received an oral, intravenous or intraperitoneal analgesic drug from the beginning of the procedure with either pulmonary recruitment or intraperitoneal lidocaine. While in Multi-modal analgesic technique, the patients received two simple and safe manoeuvres.…”

Section: Discussionmentioning

confidence: 99%

Multi-Modal Analgesic Technique for Pain Control in Patients Undergoing Diagnostic Gynecological Laparoscopy: Randomized Controlled Clinical Trial

Refaat¹,

Mawgood²,

Sonbaty³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Advancement in minimally invasive laparoscopic surgeries make it one of the best choices for both the surgeon and the patient. The anesthesiologist had to improve the techniques used to control post-operative pain. AIM: In this study, we hyposethized that multi-modal analgesic technique which is a combination of two simple techniques (intraperitoneal lidocaine and pulmonary recruitment) allow better result than using only one of them. PATIENTS AND METHOD: This randomised controlled, double-blind study was conducted in Kasr-Alainy hospital, faculty of medicine, Cairo University, Egypt from September 2017 till February 2018. Fifty female patients, scheduled for diagnostic gynecologic laparoscopy were included in the study. Patients were randomly allocated using random computer allocation with numbered closed opaque envelopes into four study group. GM (n = 12): Patients received pulmonary recruitment maneuver and intra-peritoneal Lidocaine, GL (n = 13): Patients received intra-peritoneal Lidocaine, GP (n = 13): Patients received Pulmonary Recruitment Maneuver, GC (n = 12): Patients received passive exsufflation through the port site. In the ward, patients were asked to fulfil a questionnaire about pain severity using (VAS) at 1, 3, 6-hour post-operative both the patients and the anesthesiologist that assess the (VAS) were blind of the patient group RESULTS: Regarding pain score between groups VAS 1 (the primary outcome) was lowest in GM {4.5 (3-5)} in comparison with other groups (P value = 0.015). While VAS 3 & VAS 6 wasn’t statistically significant between groups. Regarding Time of first rescue analgesia; GM {3 (1.75-4)} showed the longest time in between groups (P-value = 0.042). As regard nausea and vomiting; there was no statistically significant difference in in-between groups. CONCLUSION: Application of Multi-modal analgesic technique allows better analgesia for a longer duration than the use of the sole technique for control of abdominal pain in patients undergoing diagnostic gynaecological laparoscopy.

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“…Multimodal analgesic approaches, such as intravenous patient-controlled analgesia and patient-controlled thoracic epidural analgesia are generally used for the treatment of pain. 3 A recently introduced regional nerve blockade procedure, transversus abdominis plane (TAP) block, is becoming a popular approach as part of a multimodal strategy to optimize postoperative pain control. 4 TAP block was first described in 2001 as a local anaesthetic injection into the Petit’s triangle between the transversus abdominis and internal oblique muscles.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy cases: a retrospective evaluation of 515 patients

Tekeli

Eker²,

Bartın³

et al. 2020

J Int Med Res

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Objective To compare patients that received intravenous (i.v.) analgesics with those that received transversus abdominis plane (TAP) block for pain relief after laparoscopic cholecystectomy. Methods This retrospective study enrolled patients that had undergone laparoscopic cholecystectomy and divided them into two groups: the i.v. analgesic group (controls; group A) and the TAP block group (group T). Data retrieved from the medical records included postoperative visual analogue scale (VAS) pain scores, duration of intensive care unit (ICU) stay, total hospital stay, additional analgesic requirements and the occurrence of nausea and vomiting. Results A total of 515 patients were included (group A, n = 247; group T, n = 268). Postoperative VAS pain scores at 0, 2, 4 and 6 h and the need for additional analgesics were significantly lower in group T than in group A. Postoperative VAS pain scores at 12 and 24 h were significantly higher in group T than in group A. Postoperative nausea and vomiting were significantly lower in group T than in group A. The rate of ICU admission in group T was significantly lower than in group A. Conclusions Effective postoperative analgesia can be achieved with TAP block and undesirable effects can be reduced.

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Comparison of intravenous and intraperitoneal lignocaine for pain relief following laparoscopic cholecystectomy: a double-blind, randomized, clinical trial

Abstract: IV lignocaine is superior to IP lignocaine in providing pain relief following LC. IV lignocaine has an added advantage of bringing about the early return of bowel activity, which will further facilitate surgeons to perform LC as a day-care procedure.

Cited by 16 publications

References 14 publications

Systemic intraoperative lidocaine infusion for postoperative pain management in obese patients: A randomized, placebo controlled pilot study

Systemic intraoperative lidocaine infusion for postoperative pain management in obese patients: A randomized, placebo controlled pilot study

Multi-Modal Analgesic Technique for Pain Control in Patients Undergoing Diagnostic Gynecological Laparoscopy: Randomized Controlled Clinical Trial

The efficacy of transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy cases: a retrospective evaluation of 515 patients

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