Effect of Intravenous Lignocaine Infusion on Post-Operative Analgesia in Laparoscopic Procedures

Muhammad Zeeshan Akbar; Naveed Farhat; Syed Majid Waseem; Nabeel Tahir Butt; Kenan Anwar Khan; Nida Arif

doi:10.51253/pafmj.v76i2.9358

Authors

Muhammad Zeeshan Akbar Department of Anesthesia, Combined Military Hospital Bahawalpur/National University of Medical Sciences (NUMS) Pakistan
Naveed Farhat Department of Anesthesia, Combined Military Hospital Bahawalpur/National University of Medical Sciences (NUMS) Pakistan
Syed Majid Waseem Department of Anesthesia, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
Nabeel Tahir Butt Department of Anesthesia, Combined Military Hospital Rahim Yar Khan/National University of Medical Sciences (NUMS) Pakistan
Kenan Anwar Khan Department of Anesthesia, PNS Shifa, Karachi Pakistan
Nida Arif Department of Dermatology, Combined Military Hospital Bahawalpur/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i2.9358

Keywords:

Lignocaine, Laparoscopic Surgery, Postoperative Pain.

Abstract

Objective: To see the effect of intravenous lignocaine infusion on post-operative analgesia in patients who had laparoscopic procedures.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Bahawalpur Pakistan, from Jan to Sep 2022.

Methodology: One hundred and forty adult patients of 20-50 years with ASA class 1-2 who were planned for elective laparoscopic cholecystectomy were included, with 70 being allotted to each group. Group-A patients were given IV lignocaine while Group-B patients were given IV normal saline. Patients were observed for postoperative pain at 30 and 60 minutes after surgery by visual analogue score (VAS).

Results: Out of 140 patients, there were 41(29.28%) males and 99(70.7%) females. Heart rate rose to 100.07+9.60 bpm in Group-A from a basal rate of 73.57+3.83 bpm vs 112.41+9.22 bpm from a basal rate of 72.37+3.92 bpm in Group-B. VAS score at 300 and 60 minutes postoperatively was significantly higher in Group-B compared to Group-A (p=0.001 and 0.001 respectively).

Conclusion: We conclude that IV lignocaine infusion reduces postoperative pain leading to early recovery of patients. It also attenuates the hemodynamic response of body during intubation and extubation by stabilizing heart rate and mean arterial pressure.

Downloads

Download data is not yet available.

References

1. Soto G, González MN, Calero F. Intravenous lidocaine infusion. Rev Esp Anestesiol Reanim (Engl Ed) 2018; 65(5): 269-274.

https://doi.org/10.1016/j.redar.2018.01.004

2. Fraser SP, Foo I, Djamgoz MB. Local anaesthetic use in cancer surgery and disease recurrence: role of voltage-gated sodium channels?. Br J Anaesth 2014; 113(6): 899-902.

https://doi.org/10.1093/bja/aeu221

3. Ielpo B, Duran H, Diaz E, Fabra I, Caruso R, Malavé L, et al. A prospective randomized study comparing laparoscopic transabdominal preperitoneal (TAPP) versus Lichtenstein repair for bilateral inguinal hernias. Am J Surg 2018; 216(1): 78-83.

https://doi.org/10.1016/j.amjsurg.2017.07.016

4. Yilmaz G, Akca A, Aydin N. Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies. Ginekol Pol 2018; 89(7): 351-356.

https://doi.org/10.5603/GP.a2018.0060

5. Echeverria-Villalobos M, Stoicea N, Todeschini AB, Fiorda-Diaz J, Uribe AA, Weaver T, et al. Enhanced recovery after surgery (ERAS): a perspective review of postoperative pain management under ERAS pathways and its role on opioid crisis in the United States. Clin J Pain 2020; 36(3): 219-226.

https://doi.org/10.1097/AJP.0000000000000792

6. Radovanović D, Radovanović Z, Škorić-Jokić S, Tatić M, Mandić A, Ivković-Kapicl T. Thoracic epidural versus intravenous patient-controlled analgesia after open colorectal cancer surgery. Acta Clin Croat 2017; 56(2): 244-254.

https://doi.org/10.20471/acc.2017.56.02.07

7. Brasher C, Gafsous B, Dugue S, Thiollier A, Kinderf J, Nivoche Y, et al. Postoperative pain management in children and infants: an update. Paediatr Drugs 2014; 16(2): 129-140.

https://doi.org/10.1007/s40272-013-0062-0

8. Mercadante S. Opioid analgesics adverse effects: the other side of the coin. Curr Pharm Des 2019; 25(30): 3197-3202.

https://doi.org/10.2174/1381612825666190717152226

9. Licina A, Silvers A. Perioperative intravenous lidocaine infusion for postoperative analgesia in patients undergoing surgery of the spine: systematic review and meta-analysis. Pain Med 2022; 23(1): 45-56.

https://doi.org/10.1093/pm/pnab210

10. Yousefshahi F, Predescu O, Francisco Asenjo J. The Efficacy of Systemic Lidocaine in the Management of Chronic Pain: A Literature Review. Anesth Pain Med 2017; 7(3): e44732.

https://doi.org/10.5812/aapm.44732

11. Tk Krishnamurthy, PV Vinay. Effect of perioperative intravenous lignocaine infusion on haemodynamic responses and postoperative analgesia in laparoscopic cholecystectomy surgeries. Anesth Pain Med 2018; 8(2): e63490.

https://doi.org/10.5812/aapm.63490

12. Chapman CR, Vierck CJ. The transition of acute postoperative pain to chronic pain: an integrative overview of research on mechanisms. J Pain 2017; 18(4): 359-361.

https://doi.org/10.1016/j.jpain.2016.11.004

13. Hermanns H, Hollmann MW, Stevens MF, Lirk P, Brandenburger T, Piegeler T, et al. Molecular mechanisms of action of systemic lignocaine in acute and chronic pain: a narrative review. Br J Anaesth 2019; 123(3): 335-349.

https://doi.org/10.1016/j.bja.2019.06.014

14. Liu H, Lu F, Zhou D, et al. The Analgesic and Emotional Response to Intravenous Lidocaine Infusion in the Treatment of Postherpetic Neuralgia: A Randomized, Double-Blinded, Placebo-controlled Study. Clin J Pain 2018; 34(11): 1025-1031.

https://doi.org/10.1097/AJP.0000000000000623

15. Dunn LK, Durieux ME. Perioperative Use of Intravenous Lidocaine. Anesthesiology 2017; 126(4): 729-737.

https://doi.org/10.1097/ALN.0000000000001527

16. Ahn E, Kang H, Choi GJ, Park YH, Yang SY, Kim BG, et al. Intravenous Lidocaine for effective pain relief after a laparoscopic colectomy: A prospective, randomized, double-blind, placebo-controlled study. Int Surg 2015; 100(3): 394-401.

https://doi.org/10.9738/INTSURG-D-14-00225.1

17. Lauretti GR. Mechanisms of analgesia of intravenous Lidocaine. Rev Bras Anestesiol 2008; 58(3): 280-286.

https://doi.org/10.1590/S0034-70942008000300011

18. Wang T, Liu H, Sun JH, Wang L, Zhang JY. Efficacy of intravenous Lidocaine in improving post-operative nausea, vomiting and early recovery after laparoscopic gynaecological surgery. Exp Ther Med 2019; 17(6): 4723-4729.

https://doi.org/10.3892/etm.2019.7497

19. Tauzin-Fin P, Bernard O, Sesay M, Biais M, Richebe P, Quinart A, et al. Benefits of intravenous Lidocaine on post-operative pain and acute rehabilitation after laparoscopic nephrectomy. J Anaesthesiol Clin Pharmacol 2014; 30(3): 366-372.

https://doi.org/10.4103/0970-9185.137269

20. Dai YE, Jiang R, Su W, Wang M, Liu Y, Zuo Y. Impact of perioperative intravenous Lidocaine infusion on postoperative pain and rapid recovery of patients undergoing gastrointestinal tumor surgery: a randomized, double-blind trial. J Gastrointest Oncol 2020; 11(6): 1274-1282.

https://doi.org/10.21037/jgo-20-505