Intravenous Lidocaine for Effective Pain Relief After a Laparoscopic Colectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

Abstract

A perioperative intravenous lidocaine infusion has been reported to decrease postoperative pain. The goal of this study was to evaluate the effectiveness of intravenous lidocaine in reducing postoperative pain for laparoscopic colectomy patients. Fifty-five patients scheduled for an elective laparoscopic colectomy were randomly assigned to 2 groups. Group L received an intravenous bolus injection of lidocaine 1.5 mg/kg before intubation, followed by 2 mg/kg/h continuous infusion during the operation. Group C received the same dosage of saline at the same time. Postoperative pain was assessed at 2, 4, 8, 12, 24, and 48 hours after surgery by using the visual analog scale (VAS). Fentanyl consumption by patient-controlled plus investigator-controlled rescue administration and the total number of button pushes were measured at 2, 4, 8, 12, 24, and 48 hours after surgery. In addition, C-reactive protein (CRP) levels were checked on the operation day and postoperative days 1, 2, 3, and 5. VAS scores were significantly lower in group L than group C until 24 hours after surgery. Fentanyl consumption was lower in group L than group C until 12 hours after surgery. Moreover, additional fentanyl injections and the total number of button pushes appeared to be lower in group L than group C (P , 0.05). The CRP level tended to be lower in group L than group C, especially on postoperative day1 and 2 and appeared to be statistically significant. The satisfaction score was higher in group L than group C (P ¼ 0.024). Intravenous lidocaine infusion during an operation reduces pain after a laparoscopic colectomy.

The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

“…After reviewing the full text, 15 additional irrelevant trials were excluded. Finally, the articles considered to be suitable for this meta‐analysis consisted of 10 RCTs, enrolling a total of 527 adult patients. The search process is shown in Figure .…”

“…Of the 10 studies, 2 studies were from Belgium; 2 studies were from Korea; 2 studies were from China; and the each of the remaining 4 studies were from France, Egypt, Lithuania, and Slovenia. All studies received IV lidocaine infusion before skin incision; five studies received IV lidocaine for more than 24 hours after surgery, and the other five studies infused lidocaine less than 24 hours after surgery. Most of the loading dose of lidocaine was 1.0 to 2.0 mg/kg, and continuous dose was 1.0 to 2.0 mg/kg/h.…”

“…A previous study by MacFater et al included open and laparoscopic colorectal operations, and they did not perform meta‐analysis because of heterogeneity in studies. Second, a recent meta‐analysis by Cooke et al included nine RCTs with 405 patients undergoing colorectal surgery and included only four laparoscopic colorectal surgery studies, but we added another six studies to our meta‐analysis. Third, compared with previous studies, our study added other indicators: pain scores at rest and on movement at five different time points and CRP because pain scores at different time points are important for pain assessment, and CRP is usually a landmark for the severity of inflammation.…”

Impact of perioperative pain management on cancer recurrence: an ASRA/ESRA special article

“…Additionally, the response of lymphocyte proliferation to phytohemagglutinin-M was improved, indicating that lidocaine attenuates surgery-induced immunosuppression. While Kaba et al 145 reported that concentrations of C reactive protein (CRP) were similar in both lidocaine and control groups in patients undergoing laparoscopic colectomies, Ahn et al 146 found that in the lidocaine group the plasma concentrations of CRP were decreased in patients undergoing the same procedure within the first two postoperative days 146…”

Comparison of the Effect of Intraoperative 1 mg/kg/h and 2 mg/kg/h IV Lidocaine Infusion on Postoperative Pain and Nausea-Vomiting in Laparoscopic Gastric Bypass Surgery

“…Considering the pharmacological effects of IV lidocaine, which has both anti-inflammatory and analgesic effects (protein receptor inhibitor G and NMDA), lidocaine has been used to relieve postoperative pain [4]. According to numerous studies on various surgical procedures, intraoperative IV lidocaine infusion has been shown to reduce postoperative pain and nausea and vomiting [5][6][7][8][9][10][11][12][13][14]. Although the exact dosage is still unknown, the conducted studies have used 1-2 mg/kg/h dosages.…”