Effect Of Continuous Intravenous Lidocaine Administration For Pain Control In Patients Undergoing Laparoscopic Colorectal Surgery

Objective : To evaluate the effect of continuous intravenous lidocaine administration during surgery for short-term pain control in patients undergoing laparoscopic colorectal surgery,the postoperative use of opioid and gastrointestinal function recovery.Methods:Forty patients who underwent laparoscopic colorectal surgery were randomly assigned to lidocaine group and control group,Each group consisted of 20 patients.Intravenous administration of midazolam 0.025 mg/kg,cis-atracurium 0.2 mg/kg,sufentanil 0.5 μg/kg and etomidate 0.2 mg/kg for anesthesia induction followed by sevoflurane inhalation and Propofol continuously pumped in for anesthesia maintenance.The lidocaine group received an intravenous injection of 2% lidocaine 2 mg/kg during induction of anesthesia,followed by continuous pumping of lidocaine 1.5 mg·kg-1·h-1till the end of surgery.In the control group,saline was used in place of lidocaine.The visual analogue scales(VAS),time of first defecation,amount of opioids used intraoperatively and postoperatively,postoperative nausea and vomiting,and lidocaine toxicity symptoms were recorded at 3 h,12 h,72 h,5 d,7 d,and 30 d after surgery separately.Results:(1)Comparison of VAS scores: At 3 h,12 h,72 h,5 d and 7 d(at rest),the VAS scores in the lidocaine group were significantly lower than those in the control group(P<0.05).At 72 h(on walking)and 30 d after surgery,no significant differences in VAS scores were found between the two groups.(2)Comparison of opioid : In comparison with the control group112.5(0,150)mg,the dosage of opioids in the lidocaine group 37.5(0,93.75)mg was significantly reduced(P<0.05)(3)The comparison of postoperative adverse reactions: the symptom of nausea and vomiting were significantly reduced in the lidocaine group(P<0.05).(4)Comparison of gastrointestinal function recovery: Compared with the control group,the recovery of gastrointestinal function was significantly faster in lidocaine group.(P<0.05).(5)No symptoms of lidocaine toxicity were observed in either group.Conclusion : Continuous intravenous lidocaine administration during surgery is beneficial for postoperative pain control after laparoscopic colorectal surgery.It can also reduce the use of opioid and accelerate the recovery of gastrointestinal function.