Effect of perioperative intravenous lidocaine infusion on postoperative analgesia and recovery following laparoscopic cholecystectomy--a randomized, controlled, triple blind trial

Abstract

Objective This randomized controlled study was conducted to assess the effect of perioperative intravenous lidocaine infusion on pain, bowel function, and levels of serum IL-6, IL-8 and IL-1ra in patients subjected to larparoscopic cholecystectomy. Methods Eighty patients undergoing laparoscopic cholecystectomy were randomly allocated to receive intravenous infusion of lidocaine (bolus injection of 1.5 mg/kg lidocaine for induction of anesthesia, then a continuous infusion of 2 mg·kg-1·h-1 until the end of surgery) or an equal volume of saline. Anesthesia and multimodal perioperative analgesia were standardized. Pain scores (VAS), consumption of opioid drugs, time to first flatus, and time to first bowel movement were measured after surgery. The levels of serum IL-6, IL-8 and IL-1ra were also measured at scheduled times within 48 h. Results Seventy-one of eighty recruited patients finished the survey. The two groups of patients showed similar demographic profile. Lidocaine infusion significantly reduced pain intensity 2 h and 6 h after surgery (P<0.05) and total fentanyl consumption 24 h after surgery [lidocaine (98±16) μg vs placebo (187±20) μg, P<0.05]. Time to first flatus passage and time to first bowel movement were also significantly shorter in patients received lidocaine(P<0.05). The post-operative levels of serum IL-6 and IL-8 in the lidocaine group were lower than those in the control group. Conclusions This study suggests that perioperative infusion of lidocaine improves postoperative recovery and attenuates the excessive release of serum IL-6 and IL-8 following laparoscopic cholecystectomy. Key words: Intravenous lidocaine; Postoperative recovery; Immunocompetance