Perioperative Use of Intravenous Lidocaine Infusion to Decrease Postoperative Opioids in Colorectal Surgery: A Randomized Prospective Study

• Abdelhaq A. Elmansori

  Department of Surgery, Faculty of Medicine University of Benghazi, Libya

  Author

• Adel A. Eljamel

  Department of Surgery, Faculty of Medicine University of Benghazi, Libya

  Author

• Ezzidn E. Ellafi

  Department of Surgery, Faculty of Medicine University of Benghazi, Libya

  Author

• Farag M. Bensoaoud

  Department of Surgery, Faculty of Medicine University of Benghazi, Libya

  Author

• Laila A. Elwerfali

  Department of Surgery, Faculty of Medicine University of Benghazi, Libya

  Author

• Khalid S. Alamismaery

  Department of Surgery, Faculty of Medicine, University of Derna, Libya

  Author

• Abdelmanam A. Almabsout

  Department of Surgery, Faculty of Medicine, University of Sirt, Lib-ya

  Author

Pain is defined as an unpleasant sensory and emotional sensation provoked by real tissue damage and manifested by autonomic, psychological, and behavioral reactions. Improvement of postoperative pain control remains a significant challenge among clinicians. 40 patients aged 30-60 years, ASA 1-2 scheduled for colorectal surgery, were divided into two groups 20 patients each. Lidocaine group: (n= 20) received bolus intravenous lidocaine 20 min before incision with a dose of 1.5mg/kg followed by lidocaine infusion with a dose of 1.5mg/kg/h. Control group: (n= 20) receive intravenous lidocaine only. After premedication with a bolus dose of lidocaine at induction, the heart rate was lower in the interventional group compared with the control one until 12 hours post-operatively, then returned to be equal by 24 hours. Between recovery and one hour postoperative, intraoperative serial differences were significant only for the intervention group. After premedication and during the operation until 24 hours, postoperative mean blood pressure was significantly higher among controls. This returns to be equal by 48 hours and beyond. The postoperative VAS score and analgesic requirements were significantly lower in the lidocaine infusion group. Perioperative lidocaine infusion provides analgesia, low pain score, and decreases postoperative opioid consumption in laparoscopic colorectal surgery.

Aguggia, M. (2003). Neurophysiology of pain. Neurological Sciences, 24, s57-s60.

Canavero, S., & Bonicalzi, V. (2006). Drug therapy of trigeminal neuralgia. Expert Review of Neu-rotherapeutics, 6(3), 429-440.

Coull, J. A., Beggs, S., Boudreau, D., Boivin, D., Tsuda, M., Inoue, K., Gravel, C., Salter, M. W., & De Koninck, Y. (2005). BDNF from microglia causes the shift in neuronal anion gradient underlying neuropathic pain. Nature, 438(7070), 1017-1021.

Dennis, P. B., Davis, K., Kuppuswamy, B., & Sahajanandan, R. (2020). Intraoperative lidocaine infusion reduces analgesic and anesthetic requirements in patients with high body mass in-dex undergoing laparoscopic cholecystectomy. The Indian Anaesthetists Forum,

Doly, S., Fischer, J., Brisorgueil, M. J., Vergé, D., & Conrath, M. (2005). Pre‐and postsynaptic lo-calization of the 5‐HT7 receptor in rat dorsal spinal cord: immunocytochemical evidence. Journal of Comparative Neurology, 490(3), 256-269.

Gassner, M., Ruscheweyh, R., & Sandkühler, J. (2009). Direct excitation of spinal GABAergic in-terneurons by noradrenaline. Pain, 145(1), 204-210.

Gebhard, F., Pfetsch, H., Steinbach, G., Strecker, W., Kinzl, L., & Brückner, U. B. (2000). Is inter-leukin 6 an early marker of injury severity following major trauma in humans? Archives of surgery, 135(3), 291-295.

Groudine, S. B., Fisher, H. A., Kaufman, R. P., Patel, M. K., Wilkins, L. J., Mehta, S. A., & Lumb, P. D. (1998). Intravenous lidocaine speeds the return of bowel function, decreases postoper-ative pain, and shortens hospital stay in patients undergoing radical retropubic prostatecto-my. Anesthesia & Analgesia, 86(2), 235-239.

Gwak, Y. S., & Hulsebosch, C. E. (2011). GABA and central neuropathic pain following spinal cord injury. Neuropharmacology, 60(5), 799-808.

H Vranken, J. (2012). Elucidation of pathophysiology and treatment of neuropathic pain. Central Nervous System Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry-Central Nervous System Agents), 12(4), 304-314.

Hahnenkamp, K., Durieux, M., Hahnenkamp, A., Schauerte, S., Hoenemann, C., Vegh, V., Theil-meier, G., & Hollmann, M. (2006). Local anaesthetics inhibit signalling of human NMDA receptors recombinantly expressed in Xenopus laevis oocytes: role of protein kinase C. Brit-ish journal of anaesthesia, 96(1), 77-87.

Harvey, K. P., Adair, J. D., Isho, M., & Robinson, R. (2009). Can intravenous lidocaine decrease postsurgical ileus and shorten hospital stay in elective bowel surgery? A pilot study and lit-erature review. The American journal of surgery, 198(2), 231-236.

Heavner, J. E. (2007). Local anesthetics. Current opinion in anesthesiology, 20(4), 336-342.

Herroeder, S., Pecher, S., Schönherr, M. E., Kaulitz, G., Hahnenkamp, K., Friess, H., Böttiger, W, Bauer, H, oMarcel, GW, Durieux, M. E. (2007). Systemic lidocaine shortens length of hos-pital stay after colorectal surgery: a double-blinded, randomized, placebo-controlled trial: LWW.

Kaba, A., Laurent, S. R., Detroz, B. J., Sessler, D. I., Durieux, M. E., Lamy, M. L., & Joris, J. L. (2007). Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic co-lectomy. The Journal of the American Society of Anesthesiologists, 106(1), 11-18.

Keats, A. S., D'Alessandro, G. L., & Beecher, H. K. (1951). A controlled study of pain relief by intravenous procaine. Journal of the American Medical Association, 147(18), 1761-1763.

Kuo, C., Jao, S., Chen, K., Wong, C., Yeh, C., Sheen, M., & Wu, C. (2006). Comparison of the ef-fects of thoracic epidural analgesia and iv infusion with lidocaine on cytokine response, postoperative pain and bowel function in patients undergoing colonic surgery. BJA: British Journal of Anaesthesia, 97(5), 640-646.

Lauwick, S., Kim, D. J., Michelagnoli, G., Mistraletti, G., Feldman, L., Fried, G., & Carli, F. (2008). Intraoperative infusion of lidocaine reduces postoperative fentanyl requirements in patients undergoing laparoscopic cholecystectomy. Canadian journal of anaesthesia= Journal canadien d'anesthesie, 55(11), 754-760.

Lin, E., Calvano, S. E., & Lowry, S. F. (2000). Inflammatory cytokines and cell response in surgery. Surgery, 127(2), 117-126.

Lloyd, G., Kirby, R., Hemingway, D., Keane, F., Miller, A., & Neary, P. (2010). The RAPID proto-col enhances patient recovery after both laparoscopic and open colorectal resections. Surgi-cal endoscopy, 24, 1434-1439.

McCarthy, G. C., Megalla, S. A., & Habib, A. S. (2010). Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. Drugs, 70, 1149-1163.

Terman, G., & Bonica, J. (2001). Spinal mechanisms and their modulation. Bonica's management of pain, 3, 73-152.

Werdehausen, R., Kremer, D., Brandenburger, T., Schlösser, L., Jadasz, J., Küry, P., Bauer, I., Ara-gon, C., Eulenburg, V., & Hermanns, H. (2012). Lidocaine metabolites inhibit glycine transporter 1: a novel mechanism for the analgesic action of systemic lidocaine? The Journal of the American Society of Anesthesiologists, 116(1), 147-158.

White, P. F. (2002). The role of non-opioid analgesic techniques in the management of pain after ambulatory surgery. Anesthesia & Analgesia, 94(3), 577-585.

Woolf, C. J. (2011). Central sensitization: implications for the diagnosis and treatment of pain. Pain, 152(3), S2-S15.

Wu, C.-T., Borel, C. O., Lee, M.-S., Yu, J.-C., Liou, H.-S., Yi, H.-D., & Yang, C.-P. (2005). The interaction effect of perioperative cotreatment with dextromethorphan and intravenous lido-caine on pain relief and recovery of bowel function after laparoscopic cholecystectomy. An-esthes

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