[en] BACKGROUND: Intravenous infusion of lidocaine decreases postoperative pain and speeds the return of bowel function. The authors therefore tested the hypothesis that perioperative lidocaine infusion facilitates acute rehabilitation protocol in patients undergoing laparoscopic colectomy. METHODS: Forty patients scheduled to undergo laparoscopic colectomy were randomly allocated to receive intravenous lidocaine (bolus injection of 1.5 mg/kg lidocaine at induction of anesthesia, then a continuous infusion of 2 mg.kg.h intraoperatively and 1.33 mg.kg.h for 24 h postoperatively) or an equal volume of saline. All patients received similar intensive postoperative rehabilitation. Postoperative pain scores, opioid consumption, and fatigue scores were measured. Times to first flatus, defecation, and hospital discharge were recorded. Postoperative endocrine (cortisol and catecholamines) and metabolic (leukocytes, C-reactive protein, and glucose) responses were measured for 48 h. Data (presented as median [25-75% interquartile range], lidocaine vs. saline groups) were analyzed using Mann-Whitney tests. P<0.05 was considered statistically significant. RESULTS: Patient demographics were similar in the two groups. Times to first flatus (17 [11-24] vs. 28 [25-33] h; P<0.001), defecation (28 [24-37] vs. 51 [41-70] h; P=0.001), and hospital discharge (2 [2-3] vs. 3 [3-4] days; P=0.001) were significantly shorter in patients who received lidocaine. Lidocaine significantly reduced opioid consumption (8 [5-18] vs. 22 [14-36] mg; P=0.005) and postoperative pain and fatigue scores. In contrast, endocrine and metabolic responses were similar in the two groups. CONCLUSIONS: Intravenous lidocaine improves postoperative analgesia, fatigue, and bowel function after laparoscopic colectomy. These benefits are associated with a significant reduction in hospital stay.
Disciplines :
Anesthesia & intensive care Surgery
Author, co-author :
Kaba, Abdourahmane ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
Laurent, Stanislas R
Detroz, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Sessler, Daniel I
Durieux, Marcel E
Lamy, Maurice ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Joris, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
Language :
English
Title :
Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy
Publication date :
2007
Journal title :
Anesthesiology
ISSN :
0003-3022
eISSN :
1528-1175
Publisher :
Lippincott Williams & Wilkins, Philadelphia, United States - Pennsylvania
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Kehlet H: Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 1997; 78:606-17
Kehlet H, Dahl JB: Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 2003; 362:1921-8
Wilmore DW, Kehlet H: Management of patients in fast track surgery. BMJ 2001; 322:473-6
Bardram L, Funch-Jensen P, Kehlet H: Rapid rehabilitation in elderly patients after laparoscopic colonic resection. Br J Surg 2000; 87:1540-5
Basse L, Hjort Jakobsen D, Billesbolle P, Werner M, Kehlet H: A clinical pathway to accelerate recovery after colonic resection. Ann Surg 2000; 232:51-7
Basse L, Raskov HH, Hjort Jakobsen D, Sonne E, Billesbolle P, Hendel HW, Rosenberg J, Kehlet H: Accelerated postoperative recovery programme after colonic resection improves physical performance, pulmonary function and body composition. Br J Surg 2002; 89:446-53
Delaney CP, Fazio VW, Senagore AJ, Robinson B, Halverson AL, Remzi FH: "Fast track" postoperative management protocol for patients with high comorbidity undergoing complex abdominal and pelvic colorectal surgery. Br J Surg 2001; 88:1533-8
Kehlet H: Modification of responses to surgery by neural blockade, Neural Blockade in Clinical Anesthesia and Management of Pain, 3rd edition. Edited by Cousins MJ, Bridenbaugh PO. Philadelphia, Lippincott-Raven, 1998, pp 129-75
Kehlet H: Postoperative pain relief-what is the issue? Br J Anaesth 1994; 72:375-8
Wheatley RG, Schug SA, Watson D: Safety and efficacy of postoperative epidural analgesia. Br J Anaesth 2001; 87:47-61
Luckey A, Livingston E, Tache Y: Mechanisms and treatment of postoperative ileus. Arch Surg 2003; 138:206-14
Senagore AJ, Whalley D, Delaney CP, Mekhail N, Duepree HJ, Fazio VW: Epidural anesthesia-analgesia shortens length of stay after laparoscopic segmental colectomy for benign pathology. Surgery 2001; 129:672-6
Neudecker J, Schwenk W, Junghans T, Pietsch S, Bohm B, Muller JM: Randomized controlled trial to examine the influence of thoracic epidural analgesia on postoperative ileus after laparoscopic sigmoid resection. Br J Surg 1999; 86:1292-5
Senagore AJ, Delaney CP, Mekhail N, Dugan A, Fazio VW: Randomized clinical trial comparing epidural anaesthesia and patient-controlled analgesia after laparoscopic segmental colectomy. Br J Surg 2003; 90:1195-9
Groudine SB, Fisher HA, Kaufman RP Jr, Patel MK, Wilkins LJ, Mehta SA, Lumb PD: Intravenous lidocaine speeds the return of bowel function, decreases postoperative pain, and shortens hospital stay in patients undergoing radical retropubic prostatectomy. Anesth Analg 1998; 86:235-9
Koppert W, Weigand M, Neumann F, Sittl R, Schuettler J, Schmelz M, Hering W: Perioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery. Anesth Analg 2004; 98:1050-5
Koppert W, Ostermeier N, Sittl R, Weidner C, Schmelz M: Low-dose lidocaine reduces secondary hyperalgesia by a central mode of action. Pain 2000; 85:217-24
Hollmann MW, Durieux ME: Local anesthetics and the inflammatory response: A new therapeutic indication? ANESTHESIOLOGY 2000; 93:858-75
Rimback G, Cassuto J, Tollesson PO: Treatment of postoperative paralytic ileus by intravenous lidocaine infusion. Anesth Analg 1990; 70:414-9
Kaba A, Detroz BJ, Laurent SR, Lamy ML, Joris JL: Acute rehabilitation program after laparoscopic colectomy using intravenous lidocaine. Acta Chir Belg 2005; 105:53-8
Dzikiti TB, Hellebrekers LJ, van Dijk P: Effects of intravenous lidocaine on isoflurane concentration, physiological parameters, metabolic parameters and stress-related hormones in horses undergoing surgery. J Vet Med A Physiol Pathol Clin Med 2003; 50:190-5
Himes RS Jr, DiFazio CA, Burney RG: Effects of lidocaine on the anesthetic requirements for nitrous oxide and halothane. ANESTHESIOLOGY 1977; 47:437-40
Pypendop BH, Ilkiw JE: The effects of intravenous lidocaine administration on the minimum alveolar concentration of isoflurane in cats. Anesth Analg 2005; 100:97-101
Hodgson PS, Liu SS: Epidural lidocaine decreases sevoflurane requirement for adequate depth of anesthesia as measured by the Bispectral Index monitor. ANESTHESIOLOGY 2001; 94:799-803
Hodgson PS, Liu SS, Gras TW: Does epidural anesthesia have general anesthetic effects? A prospective, randomized, double-blind, placebo-controlled trial. ANESTHESIOLOGY 1999; 91:1687-92
Larson MD, Kurz A, Sessler DI, Dechert M, Tayefeh F, Bjorksten AR: Lidocaine does not depress reflex dilation of the pupil. Reg Anesth 1997; 22:461-5
Hollmann MW, Strumper D, Herroeder S, Durieux ME: Receptors, G proteins, and their interactions. ANESTHESIOLOGY 2005; 103:1066-78
Nagy I, Woolf CJ: Lignocaine selectively reduces C fibre-evoked neuronal activity in rat spinal cord in vitro by decreasing N-methyl-D-aspartate and neurokinin receptor-mediated post-synaptic depolarizations; implications for the development of novel centrally acting analgesics. Pain 1996; 64:59-70
Sugimoto M, Uchida I, Mashimo T: Local anaesthetics have different mechanisms and sites of action at the recombinant N-methyl-D-aspartate (NMDA) receptors. Br J Pharmacol 2003; 138:876-82
Petrenko AB, Yamakura T, Baba H, Shimoji K: The role of N-methyl-D-aspartate (NMDA) receptors in pain: A review. Anesth Analg 2003; 97:1108-16
Willert RP, Woolf CJ, Hobson AR, Delaney C, Thompson DG, Aziz Q: The development and maintenance of human visceral pain hypersensitivity is dependent on the N-methyl-D-aspartate receptor. Gastroenterology 2004; 126:683-92
Hollmann MW, Gross A, Jelacin N, Durieux ME: Local anesthetic effects on priming and activation of human neutrophils. ANESTHESIOLOGY 2001; 95:113-22
Ness TJ: Intravenous lidocaine inhibits visceral nociceptive reflexes and spinal neurons in the rat. ANESTHESIOLOGY 2000; 92:1685-91
Gray A, Kehlet H, Bonnet F, Rawal N: Predicting postoperative analgesia outcomes: NNT league tables or procedure-specific evidence? Br J Anaesth 2005; 94:710-4
Marret E, Kurdi O, Zufferey P, Bonnet F: Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: Meta-analysis of randomized controlled trials. ANESTHESIOLOGY 2005; 102:1249-60
Remy C, Marret E, Bonnet F: Effects of acetaminophen on morphine side-effects and consumption after major surgery: Meta-analysis of randomized controlled trials. Br J Anaesth 2005; 94:505-13
Kling MA, Gardner DL, Calogero AE, Coppola R, Trettau J, Kellner CH, Lefter L, Hart MJ, Cowdry RW, Post RM: Effects of local anesthetics on experiential, physiologic and endocrine measures in healthy humans and on rat hypothalamic corticotropin-releasing hormone release in vitro: Clinical and psychobiologic implications. J Pharmacol Exp Ther 1994; 268:1548-64
Birch K, Jorgensen J, Chraemmer-Jorgensen B, Kehlet H: Effect of i.v. lignocaine on pain and the endocrine metabolic responses after surgery. Br J Anaesth 1987; 59:721-4
Wallin G, Cassuto J, Hogstrom S, Linden I, Faxen A, Rimback G, Hedner T: Effects of lidocaine infusion on the sympathetic response to abdominal surgery. Anesth Analg 1987; 66:1008-13
Wolff BG, Michelassi F, Gerkin TM, Techner L, Gabriel K, Du W, Wallin BA: Alvimopan, a novel, peripherally acting mu opioid antagonist: Results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial of major abdominal surgery and postoperative ileus. Ann Surg 2004; 240:728-34
Viscusi ER, Goldstein S, Witkowski T, Andonakakis A, Jan R, Gabriel K, Du W, Techner L, Wallin B: Alvimopan, a peripherally acting mu-opioid receptor antagonist, compared with placebo in postoperative ileus after major abdominal surgery: results of a randomized, double-blind, controlled study. Surg Endosc 2006; 20:64-70
Taguchi A, Sharma N, Saleem RM, Sessler DI, Carpenter RL, Seyedsadr M, Kurz A: Selective postoperative inhibition of gastrointestinal opioid receptors. N Engl J Med 2001; 345:935-40
Kurz A, Sessler DI: Opioid-induced bowel dysfunction: pathophysiology and potential new therapies. Drugs 2003; 63:649-71
Hollmann MW, Herroeder S, Kurz KS, Hoenemann CW, Struemper D, Hahnenkamp K, Durieux ME: Time-dependent inhibition of G protein-coupled receptor signaling by local anesthetics. ANESTHESIOLOGY 2004; 100:852-60
Catterall WA: Common modes of drug action of Na+ channels: Local anesthetics, antiarrhythmics and anticonvulsants. Trends Pharmacol Sci 1987; 8:57-65
Fraser HM, Chapman V, Dickenson AH: Spinal local anaesthetic actions on afferent evoked responses and wind-up of nociceptive neurones in the rat spinal cord: Combination with morphine produces marked potentiation of antinociception. Pain 1992; 49:33-41
Inoue R, Suganuma T, Echizen H, Ishizaki T, Kushida K, Tomono Y: Plasma concentrations of lidocaine and its principal metabolites during intermittent epidural anesthesia. ANESTHESIOLOGY 1985; 63:304-10
Shono A, Sakura S, Saito Y, Doi K, Nakatani T: Comparison of 1% and 2% lidocaine epidural anaesthesia combined with sevoflurane general anaesthesia utilizing a constant bispectral index. Br J Anaesth 2003; 91:825-9
Similar publications
Sorry the service is unavailable at the moment. Please try again later.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.