Intraperitoneal and intravenous lidocaine for pain relief after Laparoscopic Cholecystectomy: A prospective randomized double-blind placebo-controlled study

Yoo Shin Choi, MD, Hyun Gang, md. Chung-Ang University Hospital.

Objective: The aim of this randomized, double-blind study trial was to evaluate the effect of intraperitoneal (IP) lidocaine instillation and intravenous (IV) lidocaine infusion on postoperative pain control after laparoscopic cholecystectomy (LC).

Methods: Seventy-two patients who underwent LC were randomly assigned to 3 groups: Group IV (intravenous lidocaine infusion, n = 26), Group IP (intraperitoneal lidocaine instillation, n = 22), and Group C (control group, IP and IV saline, n = 24). Patients in each group were evaluated with regard to postoperative pain severity (TPPS) (using the VAS), total fentanyl consumption (TFC), frequency of pushing the button for a bolus of PCA (FPB), pain control satisfaction score (PCSS) (using the NRS).

Results: Reduced TPPS, TFC, and FPB scores were observed in groups IP and IV as compared to group C (P < 0.05). PCSS was also higher in groups IP and IV than in group C (P < 0.05). TPPS was lower in group IP than group IV at 2 h, and FPB was lower in group IP than group IV from 0–2 h.

Conclusions: The IP instillation of lidocaine and IV lidocaine infusion significantly reduced postoperative pain and opioid consumption in LC patients. IV lidocaine administration could be an alternative choice for the reduction of pain following LC on account of its convenience of use.

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