Efficacy of intraperitoneal and intravenous lidocaine on pain relief after laparoscopic cholecystectomy

Abstract

Objectives: This randomized, double-blind, placebo-controlled trial evaluated intraperitoneal (IP) lidocaine administration and intravenous (IV) lidocaine infusion for postoperative pain control after laparoscopic cholecystectomy (LC). Methods: Patients who underwent LC were randomized to either group IV (intravenous lidocaine infusion), group IP (intraperitoneal lidocaine administration), or group C (control, IP and IV saline). Outcome measures were total postoperative pain severity (TPPS), total fentanyl consumption (TFC), frequency of administering patient-controlled analgesia (FPB), and a pain control satisfaction score (PCSS). Results: Significantly reduced TPPS, TFC and FPB scores were observed in groups IP (n ¼ 22) and IV (n ¼ 26) compared with controls (n ¼ 24). PCSS was higher in groups IP and IV than in controls. At 2 h postoperation, TPPS was significantly lower in group IP than group IV; at 0-2 h postoperation, FPB was lower in group IP than group IV. Conclusions: The IP administration of lidocaine and IV lidocaine infusion significantly reduced postoperative pain and opioid consumption in LC patients, compared with control infusions. For convenience, IV lidocaine could be used for pain reduction following LC; IP administration places additional burden on the surgeon.

A Randomized Controlled Trial on Efficacy and Safety of Trocar-Site Infiltration with Lidocaine for Postoperative Pain Relief after Diagnostic Laparoscopy

“…Although the quantity of pentazocine consumption in the women who did not receive lidocaine was higher than in those that received lidocaine, the difference did not reach a significant level (p = 0.57). The user-friendliness and safety of lidocaine local anesthetics is well known, and the main benefit of these agents is that they do not usually display the opioid-like side effects such as nausea, postoperative sedation, gastrointestinal paralysis, and respiratory depression, since they act directly on the tissue of application with very minimal systemic effect [19]. This justifies the choice of lidocaine in this study.…”

“…However, one previous randomized control study evaluated intraperitoneal lidocaine administration and intravenous lidocaine infusion for postoperative pain control after laparoscopic cholecystectomy (a procedure that could take longer time) but concluded that the intraperitoneal administration of lidocaine and intravenous lidocaine infusion significantly reduced postoperative pain and opioid consumption in laparoscopic cholecystectomy patients, compared with control infusions [19]. Additionally, most of the previous randomized controlled studies used longer acting local anesthetics like bupivacaine [22], ropivacaine [23], or levobupivacaine [24,25] to provide pain relief.…”

“…While the use of trocar-site infiltration with lidocaine has been examined for the prevention of postoperative pain following laparoscopic surgery [15,16], none has been studied exclusively for diagnostic laparoscopy and dye test without additional procedures. Other previous studies have only evaluated the effects of injection of lidocaine intravenously [17] or intraperitoneally [18] or both [19]. Intraperitoneal injection could be invasive [18,19].…”

“…Other previous studies have only evaluated the effects of injection of lidocaine intravenously [17] or intraperitoneally [18] or both [19]. Intraperitoneal injection could be invasive [18,19]. Thus, the available data in the management of pain using lidocaine after laparoscopic surgery are still limited [20].…”

A Review of Intravenous Lidocaine Infusion Therapy for Paediatric Acute and Chronic Pain Management

“…The lidocaine infusion was terminated either at skin closure or the end of the surgical procedure [45,186,188,[190][191][192][193][194][195][196][197][198][199][200][201][202][203][204][205][206]; 1 h after surgery/skin closure [207][208][209][210][211][212]; 1 h after arrival in the post anaesthesia care unit (PACU) [213]; 4 h post-operatively [214]; up to 8 h post-operatively (or at PACU discharge whichever occurred earlier) [187]; after a total of 12 h [215]; 24 h post-operatively [216][217][218][219][220][221][222][223]; 48 h post-operatively [215,[224][225][226]; or on the day of return of bowel function or, at the latest, on the fifth post-operative day [189]. One study did not report the cessation time for the lidocaine infusion [227].…”