Influence of dexmedetomidine and lidocaine on perioperative opioid consumption in laparoscopic intestine resection: a randomized controlled clinical trial

Abstract

NCT02616523.

The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

“…After reviewing the full text, 15 additional irrelevant trials were excluded. Finally, the articles considered to be suitable for this meta‐analysis consisted of 10 RCTs, enrolling a total of 527 adult patients. The search process is shown in Figure .…”

“…Of the 10 studies, 2 studies were from Belgium; 2 studies were from Korea; 2 studies were from China; and the each of the remaining 4 studies were from France, Egypt, Lithuania, and Slovenia. All studies received IV lidocaine infusion before skin incision; five studies received IV lidocaine for more than 24 hours after surgery, and the other five studies infused lidocaine less than 24 hours after surgery. Most of the loading dose of lidocaine was 1.0 to 2.0 mg/kg, and continuous dose was 1.0 to 2.0 mg/kg/h.…”

“…A previous study by MacFater et al included open and laparoscopic colorectal operations, and they did not perform meta‐analysis because of heterogeneity in studies. Second, a recent meta‐analysis by Cooke et al included nine RCTs with 405 patients undergoing colorectal surgery and included only four laparoscopic colorectal surgery studies, but we added another six studies to our meta‐analysis. Third, compared with previous studies, our study added other indicators: pain scores at rest and on movement at five different time points and CRP because pain scores at different time points are important for pain assessment, and CRP is usually a landmark for the severity of inflammation.…”

State of the art opioid-sparing strategies for post-operative pain in adult surgical patients

“…Agonism of this alpha receptor induces multiple downstream effects including a decrease in sympathetic tone, attenuation of the neuroendocrine and hemodynamic response to surgery, reductions in anesthetic and opioid requirements, and induction of sedation and analgesia. There have been several studies assessing its benefit for postoperative analgesia when used during the perioperative period with mixed results [83][84][85][86][87][88][89][90][91][92][93][94][95][96]. However, many studies have demonstrated reduce postoperative opioid use when the drug is administered intraoperatively, specifically following laryngectomy [83], abdominal surgeries [84,95], bariatric surgery [91,96], cesarean section [86], off-pump coronary artery bypass surgery [87], knee surgery [88,94], tonsillectomy [90], and total abdominal hysterectomy [93].…”

“…However, many studies have demonstrated reduce postoperative opioid use when the drug is administered intraoperatively, specifically following laryngectomy [83], abdominal surgeries [84,95], bariatric surgery [91,96], cesarean section [86], off-pump coronary artery bypass surgery [87], knee surgery [88,94], tonsillectomy [90], and total abdominal hysterectomy [93]. A few studies have found a lack of benefit involving other types of procedures, including major spine [89] and some abdominal surgeries [85]. The dosing of dexmedetomidine for these studies differed significantly and ranged from a single pre-incision bolus to a continuous intraoperative infusion.…”