Intraoperative Intravenous Lidocaine for prevention of Chronic Pain Syndrome

Abstract

Chronic pain after a laparoscopic cholecystectomia represents a considerable problem. One of the directions of prevention and treatment of a chronic pain syndrome are attempts of use of various adjuvants from which the most promising results showed antidepressants, antikonvulsant, antagonists of NMDA of receptors, а<sub>2</sub>-агонисты and local anesthetics. The purpose of this single center randomized, and placebo-controlled study was to evaluate the impact of IV lidocaine on CPPS (Chronic Postoperative Pain Syndrome). Materials and Methods. Following approval of the study protocol by the University ethics committee 96 patients were randomized into 2 groups for participation in this study. All patients were ASA class II and III, aged 21 years and older and undergoing elective laparoscopic cholecystectomy under general anesthesia. All patients were randomly allocated into 2 groups of equal size to receive either lidocaine infusion (Lidocaine group), or 0.9 % sodium chloride infusion (Control group). Results. The incidence of CPPS after 3 months was significantly lower in the Lidocaine group than in the Control group (10 vs 37,3 %, Fisher’s Exact Test P = 0.0069) with an overall incidence of 29.2 %, and after 6 months 18.3 % (16 vs 19.3 % accordingly, Fisher’s Exact Test P = 1.0). Date evaluation of PRI NWC (total and in each of 3 category) 6 month and 12 month after surgery with Fisher’s Exact Test and t Mann Whitney test, could not find any difference in groups. Conclusion. No differences between control group and lidocaine in 6 and 12 months were found after surgery.