Abstract
BackgroundLignocaine is a local anaesthetic agent, which is also commonly used as a perioperative analgesic adjunct to accelerate rehabilitation and enhance recovery after surgery. Lignocaine’s systemic effects on intraoperative haemodynamics and volatile anaesthetic requirements are not well explored. Therefore, we evaluated the effects of intravenous lignocaine on intraoperative volatile agent requirements and haemodynamics in patients undergoing major abdominal surgery.MethodsWe performed an analysis of 76 participants who underwent elective open radical retropubic prostatectomy. Patients received lignocaine (1.5 mg/kg loading dose) followed by an infusion (1.5 mg/kg/h) for the duration of surgery, or saline at an equivalent rate. The aims of the study were to evaluate the end-tidal sevoflurane concentration required to maintain a bispectral index of between 40 and 60. Measurements included intraoperative blood pressure, heart rate, and the volume of intravenous fluids and dosage of vasoactive medications administered.ResultsThe average end-tidal sevoflurane concentration was lower in the Lignocaine group compared to saline [1.49% (SD: 0.32) vs. 1.89% (SD: 0.29); 95% CI 0.26–0.5, p < 0.001]. In the Lignocaine group, the average mean arterial pressure was 80.3 mmHg (SD: 4.9) compared to 85.1 mmHg (SD: 5.4) in the Saline group (95% CI 2.4–7.1, p < 0.001). Systolic blood pressure was also lower in the Lignocaine group: 121.7 mmHg (SD: 6.1) vs. 128.0 mmHg (SD: 6.4) in the Saline group; 95% CI 3.5–9.2, p < 0.001, as was the mean heart rate [Lignocaine group: 74.9 beats/min (SD: 1.8) vs. 81.5 beats/min (SD: 1.7) in the Saline group, 95% CI 4.1–9.1, p < 0.001]. Maintenance fluid requirements were higher in the Lignocaine group: 3281.1 mL (SD: 1094.6) vs. 2552.6 mL (SD: 1173.5) in the Saline group, 95% CI 206–1251, p = 0.007. There were no differences in the use of vasoactive drugs.ConclusionsIntravenous lignocaine reduces volatile anaesthetic requirements and lowers blood pressure and heart rate in patients undergoing open radical prostatectomy.
Highlights
Lignocaine is a local anaesthetic agent, which is commonly used as a perioperative analgesic adjunct to accelerate rehabilitation and enhance recovery after surgery
The primary aim of this present study is to report the effects of intraoperative IV lignocaine on end-tidal sevoflurane (ET-Sevo) concentration required to maintain a bispectral index of between 40 and 60
The ET-Sevo concentration required to maintain anaesthesia was reduced by 21%, and intraoperative systolic and mean arterial pressure and heart rate were significantly lower in the Lignocaine group
Summary
Lignocaine is a local anaesthetic agent, which is commonly used as a perioperative analgesic adjunct to accelerate rehabilitation and enhance recovery after surgery. We evaluated the effects of intravenous lignocaine on intraoperative volatile agent requirements and haemodynamics in patients undergoing major abdominal surgery. Lignocaine is a local anaesthetic agent commonly used as a perioperative analgesic adjunct to accelerate. To date there is limited research evaluating the relationship between IV lignocaine and volatile anaesthetic requirements and intraoperative haemodynamics in patients undergoing major surgery [6,7,8]. Given this gap in knowledge, we evaluated the effects of lignocaine on the requirement of volatile anaesthetic agents and intraoperative haemodynamics in patients undergoing open radical retropubic prostatectomy
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