Randomized, Double-Blind Study of the Effect of Intraoperative Intravenous Lidocaine on the Opioid Consumption and Criteria for Hospital Discharge After Bariatric Surgery

Sakata, Rioko Kimiko; Lima, Roclides Castro de; Valadão, José Aparecido; Leal, Plínio da Cunha; Moura, Ed C R; Cruz, Vitor P; Oliveira, Caio Mb de

doi:10.1007/s11695-019-04340-2

Cited by 25 publications

(12 citation statements)

References 26 publications

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“…3–4 mg of morphine) is lower than the 10–16 mg decrease in morphine equivalents reported by Sakata et al. [12]. Several possibilities may explain this difference.…”

Section: Discussionmentioning

confidence: 57%

“…PACU: recovery room. examine opioid consumption as the primary endpoint [11,12]. sparing effect of lidocaine may be limited to the recovery area [9].…”

Section: Discussionmentioning

confidence: 99%

“…However, a recent meta‐analysis showed that the strength of evidence was limited and suggested that lidocaine may have no clinically‐relevant effect on postoperative pain after 24 h [9]. Neither of the two randomised trials which studied the effect of peri‐operative lidocaine infusion in bariatric surgery was designed to examine opioid consumption as the primary endpoint [11, 12]. The first one, including 50 patients, showed that lidocaine improved the global score of postoperative quality of recovery questionnaire (QoR‐40) on postoperative day 1 [11].…”

Section: Discussionmentioning

confidence: 99%

“…Although the pain component of the QoR‐40 was improved, the difference between groups in opioid consumption was 1.75 mg of intravenous morphine. The second study including 58 patients, showed that lidocaine did not modify the time to gastrointestinal recovery and the time to meet discharge criteria [12]. The 24 h postoperative mean intravenous morphine consumption was 10 mg in the lidocaine group but 26 mg in the control group.…”

Section: Discussionmentioning

confidence: 99%

“…Although the pain component of the QoR-40 was improved, the difference between groups in opioid consumption was 1.75 mg of intravenous morphine. The second study including 58 patients, showed that lidocaine did not modify the time to gastrointestinal recovery and the time to meet discharge criteria[12]mg in the lidocaine group but 26 mg in the control group. Both studies could suggest that lidocaine could decrease postoperative opioid consumption, but the following limitations preclude any conclusion.…”

mentioning

confidence: 95%

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Effect of intra‐operative intravenous lidocaine on opioid consumption after bariatric surgery: a prospective, randomised, blinded, placebo‐controlled study

Plass¹,

Nicolle²,

Zamparini³

et al. 2020

Anaesthesia

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Summary Peri‐operative lidocaine infusion warrants investigation in bariatric surgery because obese patients present different physiological and pharmacological risks. This single‐centre, prospective, randomised double‐blind placebo‐controlled study enrolled obese patients scheduled for laparoscopic bariatric surgery using an enhanced recovery protocol. Patients received either lidocaine (bolus of 1.5 mg.kg−1, then a continuous infusion of 2 mg.kg−1.h−1 until the end of the surgery, then 1 mg.kg−1.h−1 for 1 h in the recovery area) or identical volumes and rates of 0.9% saline. The primary outcome was the consumption of the equivalent of oxycodone consumption over the first 3 postoperative days. Secondary outcomes were: postoperative pain; incidence of nausea and vomiting; bowel function recovery; and lengths of stay in the recovery area and in hospital. Plasma concentrations of lidocaine were measured. On the 178 patients recruited, data were analysed from 176. The median (IQR [range]) equivalent intravenous oxycodone consumption was 3.3 mg (0.0–6.0 [0.0–14.5]) and 5.0 mg (3.3–7.0 [3.3–20.0]) in the lidocaine and saline groups, respectively (difference between medians (95%CI): 1.7 (0.6–3.4) mg; p = 0.004). Length of stay in the recovery area, postoperative pain, nausea and vomiting, day of recovery of bowel function, and length of stay in hospital were not different between groups. Mean (SD) lidocaine plasma concentrations were 2.44 (0.70) µg.ml−1 and 1.77 (0.51) µg.ml−1 at the end of surgery and 1 hour after the end of infusion, respectively. Lidocaine infusion during bariatric surgery resulted in a clinically non‐relevant difference in postoperative oxycodone consumption.

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“…3–4 mg of morphine) is lower than the 10–16 mg decrease in morphine equivalents reported by Sakata et al. [12]. Several possibilities may explain this difference.…”

Section: Discussionmentioning

confidence: 57%

“…PACU: recovery room. examine opioid consumption as the primary endpoint [11,12]. sparing effect of lidocaine may be limited to the recovery area [9].…”

Section: Discussionmentioning

confidence: 99%