Comparison of dose–response to two different doses of intravenous lidocaine for analgesia in patients undergoing elective laparoscopic cholecystectomy under general anesthesia

Abstract

BackgroundVarious studies have demonstrated the analgesic benefit of systemic lidocaine in the perioperative setting, especially during laparoscopic abdominal surgery. However, the best appropriate dose for an administered bolus and continuous infusion of lignocaine is unclear. Our aim is to compare the effect of two different doses of intravenous lidocaine for analgesia in patients undergoing elective laparoscopic cholecystectomy under general anesthesia. Fifty-four patients of ASA PS I or II, aged between 18 and 65 years undergoing elective laparoscopic cholecystectomy under general anesthesia were randomly divided into two groups of 26 patients each. Patients in group A received an intravenous bolus injection of lidocaine 1.5 mg/kg slowly over 10 min, prior to induction and then followed by a continuous infusion at the rate of 1.5 mg/kg/h via infusion pump whereas group B patients received intravenous lidocaine bolus of 1.5 mg/kg slowly over 10 min followed by infusion at the rate of 2 mg/kg/h. Postoperative analgesia was assessed by VAS score, time to first analgesic dose, and total consumption of rescue analgesic in 24 h.ResultsThere was a statistically significant difference in mean VAS Scores between the two groups at different time intervals postoperatively. Time to first rescue analgesia was earlier in group A (30.65 min) compared to group B (49.42 min) and the difference was statistically significant. Total consumption of rescue analgesic was higher in group A with a mean of 178.85 mg compared to 126.92 mg in group B.ConclusionBoth the infusion doses of Lidocaine provided clinically adequate analgesia postoperatively but the infusion dose of 2 mg/kg/h had a mean VAS score significantly lower than 1.5 mg/kg/h.