Abstract
To investigate the role of pre- and intra-operative lidocaine infusion on post-operative pain management. The interventional, prospective study was conducted from September 2019 to June 2020 at the Pakistan Ordnance Factories Hospital, Wah Cantt, Pakistan, and comprised patients aged 18-60 years undergoing elective cholecystectomy who were randomised into intervention group A and control group B. Group A was given a bolus dose of lidocaine hydrochloride 2 mg/kg in addition to the standard anaesthesia protocol, while group B was given continuous intravenous infusion of 0.9% normal saline along with the standard protocol. Blood samples for interleukins 6 and 8 were taken at baseline, and then at 2, 6 and 8 hours Post-operatively. Data was analysed using SPSS 23. Of the 40 patients, 20(50%) were in each of the two groups. There was a marked decrease in interleukins 6 and 8 levels group A compared to group B (p<0.05). Interleukin 8 level showed a marked decline compared to that of interleukin 6 (p<0.05). A decrease in interleukins 6 and 8 levels highlighted the anti-inflammatory role of lidocaine and resulted in a decrease in post-operative opioid consumption.
Highlights
Management of pain is one of medicine’s greatest challenges
Alternative analgesic methods have been used in place of opioids for analgesia, amongst which one is the use of systemic infusion of lidocaine, a local anaesthetic, pre, intra, and post-operatively [4]
There was a marked decrease in interleukin 6 (IL-6) and IL-8 levels in group A compared to group B (Tables 2-3)
Summary
Management of pain is one of medicine’s greatest challenges. The clinician must rely on the patient’s description of pain and its intensity. Pain generally indicates some underlying inflammatory issues, but post-surgery pain occurs because of the release of inflammatory cytokines in response to surgical trauma. Pain can affect the autonomic and behavioural responses of the individual [1]. Opioids were the sole analgesic used for severe pain[2]. Till the 19th century, pain management was not proper, and it was due to the advances in management strategies that this field got modified. Alternative analgesic methods have been used in place of opioids for analgesia, amongst which one is the use of systemic infusion of lidocaine, a local anaesthetic, pre-, intra-, and post-operatively [4]
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