Abstract
The purpose of this research is to assess the effect of perioperative intravenous lidocaine infusion of 1.25mg/kgBW/H on the bowel sounds recovery and pain intensity after laparoscopy cholecystectomy. The research used the experimental method, i.e. 42 patients who met the inclusive criteria and who would undergo laparoscopic cholecystectomy surgery under the general anesthesia, using the randomized double blind technique, and then were divided into two groups. The Treatment Group (KL, n = 21) received perioperative intravenous lidocaine infusion of 1.25 mg/kgB/H, while the control group (KN, n = 21) received the perioperative infusion of placebo of 0.9 NaCl. After the surgery, the assessments of the bowel sounds recovery time, the NRS scores at 2h, 6h, 12h, and 24h and the fentanyl requirement within 24 hours with PCA were conducted. The data were analyzed using the Chi square test, independent-t test, and Mann-Whitney test with p<0.05 to reveal the statistical significance. The research results indicated that the time of the bowel sounds recovery in KL group was 147.14 ± 24.928 minutes, faster than in KN group it was 322.86 ± 34.079 minutes (p=0.000). The postoperative NRS score at 2h and 6h in KL group was lower than the KN group with p=0,000, but there was no significant difference in the postoperative NRS score at 12h and 24h in both groups (p>0.05). The postoperative fentanyl requirement was lower in KL group (114.29 ± 31.196) mcg compared to the KN group (258.33 ± 27.764) mcg with p=0.000. The Perioperative intravenous lidocaine infusion of 1.25 mg/kgBB/h could speed up the bowel sounds recovery and reduce the pain intensity after laparoscopic cholecystectomy.
Highlights
Acute pain after surgery and acute postoperative pain and postoperative ileus (IPO) usually occur in patients after abdominal surgery
The results showed that the pain intensity and postoperative analgesic needs were significantly lower in the lidocaine group
From the results of this test, there were no significant differences (p
Summary
Acute pain after surgery and acute postoperative pain and postoperative ileus (IPO) usually occur in patients after abdominal surgery. Analgesic opioid is effective in reducing postoperative pain but can cause undesirable side effects, such as respiratory depression, nausea, vomiting, somnolence and IPO. One of drugs that has promised in providing analgesia, before, during, and after a surgical procedure is lidocaine (Grady et al, 2012). Lidocaine has the effect of analgesia, antihyperalgesia, and anti-inflammation after intravenous administration (Deeb et al, 2013). Recent research has shown that intravenous lidocaine which is given as a single dose or as a continuous infusion is beneficial in restoring intestinal motility postoperatively and has a biochemical effect on the pain process (Grady et al.,2012). The use of intravenous lidocaine after major abdominal surgery has shown a less morphine effect (Martin et al, 2008)
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