Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal
gastrectomy: a prospective, randomized, double-blind, placebo-controlled study.
Author(s): Yon JH(1), Choi GJ(2), Kang H(2), Park JM(3), Yang HS(4).
Affiliation(s): Author information:
(1)The Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik
Hospital, Seoul, Korea.
(2)The Departments of Anesthesiology and Pain Medicine, College of Medicine,
Chung-Ang University, Seoul, Korea.
(3)The Department of Surgery, College of Medicine, Chung-Ang University, Seoul,
Korea.
(4)The Department of Otolaryngology and Head-Neck Surgery, College of Medicine,
Chung-Ang University, Seoul, Korea.
Publication date & source: 2014, Can J Surg. , 57(3):175-82
BACKGROUND: Pre-emptive intravenous lidocaine infusion is known to improve
postoperative pain in abdominal surgery. We assessed the effect of intravenous
lidocaine infusion in patients who underwent subtotal gastrectomy.
METHODS: We conducted a double-blind, placebo-controlled study with patients
undergoing subtotal gastrectomy for early gastric cancer divided into 2 groups: 1
group received intravenous lidocaine infusion preoperatively and throughout
surgery, and the other received normal saline infusion (placebo). We assessed
postoperative outcomes, including pain scores on a visual analogue scale (VAS),
administration frequency of patient-controlled analgesia (PCA) and the amount of
consumed fentanyl. Postoperative nausea and vomiting, length of hospital stay
(LOS), time to return to regular diet and patient satisfaction at discharge were
evaluated.
RESULTS: There were 36 patients in our study. Demographic characteristics were
similar between the groups. The VAS pain scores and administration frequency of
PCA were significantly lower in the lidocaine group until 24 hours after surgery,
and fentanyl consumption was significantly lower in this group until 12 hours
postoperatively compared with the placebo group. The total amount of consumed
fentanyl and the total administration frequency of PCA were significantly lower
in the lidocaine than the control group. No significant differences were detected
in terms of nausea and vomiting, return to regular diet, LOS and patient
satisfaction, and there were no reported side-effects of lidocaine.
CONCLUSION: Intravenous lidocaine infusion reduces pain during the postoperative
period after subtotal gastrectomy.
|