Intraoperative systemic infusion of lidocaine reduces postoperative pain after lumbar surgery: a double-blinded, randomized, placebo-controlled clinical trial

• Published in: The spine journal 2014-08, Vol.14 (8), p.1559-1566
• Main Authors: Kim, Kyoung-Tae, MD, PhD, Cho, Dae-Chul, MD, PhD, Sung, Joo-Kyung, MD, PhD, Kim, Young-Baeg, MD, PhD, Kang, Hyun, MD, PhD, Song, Kwang-Sup, MD, PhD, Choi, Geun-Joo, MD
• Format: Article
• Language: English
• Subjects: Adult; Analgesia, Patient-Controlled; Analgesics, Opioid - therapeutic use; Anesthetics, Local - administration & dosage; Anesthetics, Local - therapeutic use; Diskectomy - adverse effects; Double-Blind Method; Female; Fentanyl - therapeutic use; Humans; Inflammation; Infusions, Intravenous; Laminectomy - adverse effects; Lidocaine; Lidocaine - administration & dosage; Lidocaine - therapeutic use; Lumbar Vertebrae - surgery; Male; Microdiscectomy; Middle Aged; Muscle injury; Opioid consumption; Orthopedics; Pain Measurement; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; Patient Satisfaction; Postoperative pain; Prospective Studies; Treatment Outcome
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2013.09.031

Abstract Background context Analgesic effect of lidocaine infusion on postoperative pain. Purpose The aim of this study was to evaluate the analgesic effect of lidocaine infusion on postoperative pain after lumbar microdiscectomy. Study design This study used a prospective, randomized, double-blinded, and placebo-controlled clinical trial. Patient sample Fifty-one patients participated in this randomized, double-blinded study. Outcome measures The primary outcome was the visual analog scale (VAS) (0–100 mm) pain score at 4 hours after surgery. The secondary outcomes were the VAS pain score at 2, 8, 12, 24, and 48 hours after surgery, the frequency with which patients pushed the button (FPB) of the patient-controlled analgesia system, and the fentanyl consumption at 2, 4, 8, 12, 24, and 48 hours after surgery. Other outcomes were satisfaction scores regarding pain control and the overall recovery process, incidence of postoperative nausea and vomiting (PONV), and length of hospital stay (HS). Methods Preoperatively and throughout the surgery, Group L received intravenous lidocaine infusion (a 1.5-mg/kg bolus followed by a 2-mg/kg/h infusion until the end of the surgical procedure) and Group C received normal saline infusion as a placebo. Results The VAS scores and fentanyl consumption were significantly lower in Group L compared with Group C except at 48 h after surgery (p