Pre- And Intra-operative Lidocaine Injection for Preemptive Analgesics in Laparoscopic Gastrectomy: A Prospective Randomized Double-Blind Placebo-controlled Study

Tae Han Kim, MD, Hyun Kang, MD, Yoo Shin Choi, MD, Joong Min Park, MD, Kyong Choun Chi, MD. College of Medicine, Chung-Ang University

Background
The preemptive intravenous injection of local anesthetics is known to improve postoperative pains in abdominal surgery. The aim of this study is to assess the effect of intravenous lidocaine injection and analyze precise amount of pain by computerized PCA in patients who were undergoing laparoscopy assisted distal gastrectomy(LADG).
Method
Double- blind placebo control was designed and 34 patients undergoing LADG for early gastric cancer were divided into two groups. Preoperatively and throughout the surgery group I received intravenous lidocaine injection and group C received normal saline injection for placebo. Postoperative outcomes, visual analogue scale (VAS), the button hit counts (BHC) from patient-controlled analgesia (PCA) and amount of consumed fentanyls were measured postoperatively.
Results
The demographic data were similar between the groups. VAS score, BHC and fentanyl consumption were reduced in group I compared to group C (p<0.05). Distinctively, fentanyl consumption and BHC in group I showed significant decrease during the first 12hours of the study (p<0.05). Postoperative adverse event showed no difference except nausea were more frequent in the placebo group (p<0.039).
Conclusion
In this study intravenous lidocaine injection showed significant reduction in fentanyl consumption and pain during the earlier postoperative time with more favorable outcomes.