Intraoperative intravenous lidocaine reduces hospital length of stay following open gastrectomy for stomach cancer in men

• Published in: Journal of clinical anesthesia 2012-09, Vol.24 (6), p.465-470
• Main Authors: Kang, Jin Gu, MD, Kim, Myung Hee, MD, PhD, Kim, Eun Hee, MD, Lee, Sang Hyun, MD
• Format: Article
• Language: English
• Subjects: Analgesics; Analgesics, Opioid - administration & dosage; Analgesics, Opioid - therapeutic use; Anesthesia; Anesthesia & Perioperative Care; Anesthetics, Local - administration & dosage; Anesthetics, Local - therapeutic use; Double-Blind Method; Gastrectomy - methods; Hospitalization - statistics & numerical data; Hospitals; Hospitals, University; Humans; Ileus - epidemiology; Infusions, Intravenous; Intraoperative Care - methods; Length of Stay; Lidocaine - administration & dosage; Lidocaine - therapeutic use; Male; Meperidine - administration & dosage; Meperidine - therapeutic use; Middle Aged; Pain Measurement; Pain Medicine; Pain, Postoperative - drug therapy; Pain, Postoperative - prevention & control; Prospective Studies; Stomach Neoplasms - surgery; Time Factors; Wound healing
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2012.02.006

Abstract Study Objective To evaluate whether intraoperative low-dose lidocaine infusion decreases postoperative analgesic consumption, ileus, and duration of hospital stay. Design Prospective, randomized, double-blinded trial. Setting Operating room in a university hospital. Patients 48 ASA physical status 1 and 2 men scheduled for subtotal gastrectomy. Interventions Patients were randomly allocated to two groups to receive either intravenous (IV) lidocaine 1.5 mg/kg 20 minutes before incision followed by a continuous lidocaine infusion of 1.5 mg/kg/hr until the end of surgery (lidocaine group) or saline in a similar manner (control group). Measurements Outcomes such as pain intensity, postoperative analgesic consumption, duration of ileus, and hospital length of stay (LOS) were recorded. Main Results There were no differences in total consumption of IV patient-controlled analgesia (IVPCA) or pain scores at 24, 48, or 72 hours postoperatively. However, lidocaine group patients had significantly decreased average supplemental pethidine requirement per patient for pain control until 72 hours postoperatively [150 (75-200) mg vs 50 (50-150) mg, P = 0.039] and hospital LOS (9.5 ± 3 d vs 8.7 ± 1 d, P = 0.006, 95% CI: - 0.3 - 1.9 d) than control group patients. However, no differences were noted between the groups in pain intensity or duration of ileus. Conclusions Intraoperative IV low-dose lidocaine infusion decreased opioid consumption and hospital LOS after gastrectomy.