Effects of Intra-operative Infusion of Lidocaine on Postoperative Pain and Quality of Recovery in Patients Undergoing Gynecological Laparoscopic Surgery: A Randomized Controlled Trial

Overview

Journal J Anaesthesiol Clin Pharmacol

Specialty Anesthesiology

Date 2022 Sep 29

PMID 36171919

Authors

Shikha Awal

Anju Romina Bhalotra

Saurabh Sharma

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Early recovery is desirable after day care surgery. Intravenous lidocaine has anti-inflammatory, anti-hyperalgesic, and analgesic effects and by reducing postoperative pain, nausea, vomiting, and duration of postoperative ileus and hospital stay, might be a useful adjuvant to improve recovery after gynecological laparoscopic surgery.

Material And Methods: Fifty female patients, aged 18-55 years, undergoing gynecological laparoscopic surgery were randomly allocated to two groups. In Group L, patients received intravenous lidocaine 1.5 mg/kg at induction of anesthesia followed by infusion of 2 mg/kg/hour until the completion of surgery and in Group NS, patients received normal saline infusion. The Global QoR-40 score at 24 hours, pain score in PACU and at 24 hours, nausea/vomiting, PADSS score in PACU and analgesic consumption over 24 hours were assessed and data were analyzed using SPSS version 17 software.

Results: Demographic data were comparable in both groups. The mean Global QoR-40 score in Group L was 197.30 ± 2.3 versus 178.74 ± 6.02 in Group NS (P < 0.001). The mean time to attain PADSS ≥9 was 50 min shorter in Group L than in Group NS (P < 0.001). Nausea, vomiting, and anti-emetic requirement were also significantly reduced in Group L as compared to Group NS (P = 0.005) as was the mean pain score over 24 h (P < 0.001) and the total analgesic consumption over the first 24 h after surgery (P < 0.005).

Conclusion: Intraoperative intravenous lidocaine infusion resulted in an improved overall Quality of Recovery in patients undergoing ambulatory gynecological surgery.

References

Tikuisis R, Miliauskas P, Samalavicius N, Zurauskas A, Samalavicius R, Zabulis V . Intravenous lidocaine for post-operative pain relief after hand-assisted laparoscopic colon surgery: a randomized, placebo-controlled clinical trial. Tech Coloproctol. 2013; 18(4):373-80. PMC: 3962581. DOI: 10.1007/s10151-013-1065-0. View

Dirks J, Moiniche S, Dahl J . Mechanisms of postoperative pain: clinical indications for a contribution of central neuronal sensitization. Anesthesiology. 2002; 97(6):1591-6. DOI: 10.1097/00000542-200212000-00035. View

Kaba A, Laurent S, Detroz B, Sessler D, Durieux M, Lamy M . Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. Anesthesiology. 2007; 106(1):11-8. DOI: 10.1097/00000542-200701000-00007. View

Herroeder S, Pecher S, Schonherr M, Kaulitz G, Hahnenkamp K, Friess H . Systemic lidocaine shortens length of hospital stay after colorectal surgery: a double-blinded, randomized, placebo-controlled trial. Ann Surg. 2007; 246(2):192-200. PMC: 1933564. DOI: 10.1097/SLA.0b013e31805dac11. View

Koppert W, Weigand M, Neumann F, Sittl R, Schuettler J, Schmelz M . Perioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery. Anesth Analg. 2004; 98(4):1050-1055. DOI: 10.1213/01.ANE.0000104582.71710.EE. View

Kim M, Lee K, Park S, Kim S, Park H, Yoo Y . Effects of systemic lidocaine versus magnesium administration on postoperative functional recovery and chronic pain in patients undergoing breast cancer surgery: A prospective, randomized, double-blind, comparative clinical trial. PLoS One. 2017; 12(3):e0173026. PMC: 5333858. DOI: 10.1371/journal.pone.0173026. View

Marret E, Rolin M, Beaussier M, Bonnet F . Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br J Surg. 2008; 95(11):1331-8. DOI: 10.1002/bjs.6375. View

Kim M, Kim M, Lee J, Kim S, Lee J . Intravenously Administered Lidocaine and Magnesium During Thyroid Surgery in Female Patients for Better Quality of Recovery After Anesthesia. Anesth Analg. 2018; 127(3):635-641. DOI: 10.1213/ANE.0000000000002797. View

Rimback G, Cassuto J, Tollesson P . Treatment of postoperative paralytic ileus by intravenous lidocaine infusion. Anesth Analg. 1990; 70(4):414-9. View

10.

Vigneault L, Turgeon A, Cote D, Lauzier F, Zarychanski R, Moore L . Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials. Can J Anaesth. 2010; 58(1):22-37. DOI: 10.1007/s12630-010-9407-0. View

11.

Sun Y, Li T, Wang N, Yun Y, Gan T . Perioperative systemic lidocaine for postoperative analgesia and recovery after abdominal surgery: a meta-analysis of randomized controlled trials. Dis Colon Rectum. 2012; 55(11):1183-94. DOI: 10.1097/DCR.0b013e318259bcd8. View

12.

Weibel S, Jokinen J, Pace N, Schnabel A, Hollmann M, Hahnenkamp K . Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis. Br J Anaesth. 2016; 116(6):770-83. DOI: 10.1093/bja/aew101. View

13.

Ramsay M, Savege T, Simpson B, Goodwin R . Controlled sedation with alphaxalone-alphadolone. Br Med J. 1974; 2(5920):656-9. PMC: 1613102. DOI: 10.1136/bmj.2.5920.656. View

14.

De Oliveira Jr G, Duncan K, FitzGerald P, Nader A, Gould R, McCarthy R . Systemic lidocaine to improve quality of recovery after laparoscopic bariatric surgery: a randomized double-blinded placebo-controlled trial. Obes Surg. 2013; 24(2):212-8. DOI: 10.1007/s11695-013-1077-x. View

15.

Cassuto J, Wallin G, HOGSTROM S, Faxen A, Rimback G . Inhibition of postoperative pain by continuous low-dose intravenous infusion of lidocaine. Anesth Analg. 1985; 64(10):971-4. View

16.

Holdgate A, Asha S, Craig J, Thompson J . Comparison of a verbal numeric rating scale with the visual analogue scale for the measurement of acute pain. Emerg Med (Fremantle). 2004; 15(5-6):441-6. DOI: 10.1046/j.1442-2026.2003.00499.x. View

17.

De Oliveira Jr G, FitzGerald P, Streicher L, Marcus R, McCarthy R . Systemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery. Anesth Analg. 2012; 115(2):262-7. DOI: 10.1213/ANE.0b013e318257a380. View

18.

Kim K, Cho D, Sung J, Kim Y, Kang H, Song K . Intraoperative systemic infusion of lidocaine reduces postoperative pain after lumbar surgery: a double-blinded, randomized, placebo-controlled clinical trial. Spine J. 2013; 14(8):1559-66. DOI: 10.1016/j.spinee.2013.09.031. View

19.

McKay A, Gottschalk A, Ploppa A, Durieux M, Groves D . Systemic lidocaine decreased the perioperative opioid analgesic requirements but failed to reduce discharge time after ambulatory surgery. Anesth Analg. 2009; 109(6):1805-8. DOI: 10.1213/ANE.0b013e3181be371b. View

20.

Choi K, Nam K, Lee J, Chung W, Kang S, Joe Y . The Effects of Intravenous Lidocaine Infusions on the Quality of Recovery and Chronic Pain After Robotic Thyroidectomy: A Randomized, Double-Blinded, Controlled Study. World J Surg. 2016; 41(5):1305-1312. DOI: 10.1007/s00268-016-3842-1. View