Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal gastrectomy: a prospective, randomized, double-blind, placebo-controlled study

Abstract

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.

Figures

Fig. 1

Flow of patients through the study. PONV = postoperative nausea and vomiting.

Fig. 2

Visual analogue scale (VAS) pain score. Values are expressed as means ± standard errors of the mean. *p < 0.05 compared with the control group.

Fig. 3

Frequency of pushing the button of patient-controlled analgesia (PCA) system. Values are expressed as means ± standard errors of the mean. *p < 0.05 compared with the control group.

Fig. 4

Fentanyl consumption. Values are expressed as means ± standard errors of the mean. *p < 0.05 compared with the control group.

Fig. 5

C-reactive protein (CRP). Values are expressed as means ± standard errors of the mean. *p < 0.05 compared with the control group. POD = postoperative day.