The effect of intraoperative lidocaine infusion on perioperative opioid consumption for laparoscopic cholecystectomy

Abstract

Objective The aim of this study was to determine the role of intraoperative lidocaine infusion in reducing perioperative pain and analgesia requirement in patients undergoing laparoscopic cholecystectomy. Background An alternative approach to pain relief in laparoscopic cholecystectomy is the use of intravenous (i.v.) lidocaine intraoperatively, which decreases perioperative analgesic requirement. Patients and methods This double-blinded randomized study was conducted on 60 patients of both sexes. Patients between 40 and 50 years of age, of American Society of Anesthesiologists I and II physical status, and scheduled for laparoscopic cholecystectomy were included in the study. Patients were randomly assigned using computerized software to one of the two groups, each containing 30 patients. Group L (the study group) was infused with lidocaine at a rate of 2 mg/kg/h, and group S (the control group) was infused with normal saline at a rate of 2 mg/kg/h. Anesthesia was induced with i.v. fentanyl 2 mg/kg and propofol 2–3 mg/kg. Patients received supplemental i.v. dose of morphine 0.1 mg/kg intraoperatively if needed. (Additional morphine intraoperatively was indicated when heart rate and mean arterial blood pressure increased more than 20% of preoperative heart rate and mean arterial blood pressure values.) The total amount of opioid used for patients intraoperatively and postoperatively was recorded. All patients were asked to quantify their pain on a visual analog scale immediately postoperatively and every 4 h until hospital discharge. Results In the current study, there was a significant difference as regards postoperative pain; it was significantly lower in the lidocaine group. Total analgesic dose required was significantly lower in the lidocaine group. Conclusion Perioperative i.v. lidocaine provides analgesia and low pain scores after laparoscopic cholecystectomy. The use of lidocaine intraoperatively decreases perioperative opioid consumption.