Acute Rehabilitation Program after Laparoscopic Colectomy using Intravenous lidocaine

[en] The concept of postoperative acute rehabilitation was introduced to accelerate postoperative recovery and improve outcome. We investigated whether intravenous lidocaine infusion, which decreases postoperative pain and speeds the return of bowel function, can be used instead of epidural analgesia in an acute rehabilitation protocol for patients undergoing laparoscopic colectomy. Methods : Twenty eight consecutive patients scheduled for laparoscopic colectomy were prospectively included in this case series study. Segmental colectomy was performed only for benign pathology. Intraoperative opioid use was restricted. After a bolus injection of lidocaine 1.5 mg·kg-1, an infusion (2 mg·kg-1·h-1, IV) was started before pneumoperitoneum. Balanced analgesia was used to reduce postoperative opioid consumption. Patients were allowed to drink 6 h postoperatively. The day after surgery, patients were allowed to eat a normal breakfast. Enforced mobilisation and ambulation were required from the patients. Our goal was to discharge patients within 3 days after surgery. Postoperative pain was measured. Time to first flatus, defecation, and hospital discharge were recorded. Results : Mean postoperative pain at rest and mobilisation remained below 30 mm on a 100 mm visual analogue scale. Time to first flatus, defecation, and hospital discharge were 29 ± 13 h, 38 ± 13 h, and 3.0 ± 1.0 days, respectively. Conclusion : Acute rehabilitation after laparoscopic colectomy using IV lidocaine gives similar outcomes to those reported using epidural analgesia.

Disciplines :

Surgery

Author, co-author :

Kaba, Abdourahmane ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation

Detroz, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation

Laurent, S. R.

Lamy, Maurice ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation

Joris, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation

Language :

English

Title :

Acute Rehabilitation Program after Laparoscopic Colectomy using Intravenous lidocaine

Publication date :

2005

Journal title :

Acta Chirurgica Belgica

ISSN :

1784-3421

eISSN :

2577-0160

Publisher :

Acta Medica Belgica, Bruxelles, Belgium

Volume :

105

Pages :

53-58

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 05 May 2009

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