Effects of Intravenous Versus Epidural Lidocaine Infusion on Pain Intensity and Bowel Function After Major Large Bowel Surgery: a Double-Blind Randomized Controlled Trial

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• 作者：Chryssoula Staikou (1)
  Alexandra Avramidou (2)
  Georgios D. Ayiomamitis (3)
  Spyros Vrakas (4)
  Eriphili Argyra (1)
  
• 关键词：Intravenous lidocaine ; Epidural lidocaine ; Open large bowel surgery ; Postoperative ileus
• 刊名：Journal of Gastrointestinal Surgery
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：18
• 期：12
• 页码：2155-2162
• 全文大小：771 KB
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• 作者单位：Chryssoula Staikou (1)
  Alexandra Avramidou (2)
  Georgios D. Ayiomamitis (3)
  Spyros Vrakas (4)
  Eriphili Argyra (1)
  
  1. First Department of Anesthesiology, Aretaieion Hospital, University of Athens School of Medicine, 76 Vass. Sophias Av., 11528, Athens, Greece
  2. Department of Anesthesiology, Tzaneion General Hospital, Zanni & 1 Afentouli Strs, 18536, Piraeus, Greece
  3. Second Department of Surgery, Tzaneion General Hospital, Zanni & 1 Afentouli Strs, 18536, Piraeus, Greece
  4. Tzaneion General Hospital, Zanni & 1 Afentouli Strs, 18536, Piraeus, Greece
  
• ISSN：1873-4626

文摘

Background We compared the effects of intravenous lidocaine (IVL) with lumbar epidural lidocaine analgesia (LEA) on pain and ileus after open colonic surgery. Methods Between December 2011 and February 2013, 60 patients were randomly allocated to IVL, LEA, or control group. The IVL group received intraoperatively lidocaine 2?% intravenously (1.5?mg/kg bolus, 2?mg/kg/h infusion) and normal saline (NS) epidurally. The LEA group received lidocaine epidurally (1.5?mg/kg bolus, 2?mg/kg/h infusion) and NS intravenously. The control group received NS both intravenously and epidurally, as bolus and infusion. All NS volumes were calculated as if containing lidocaine 2?% at the aforementioned doses. We assessed pain intensity at rest/cough at 1, 2, 4, 12, 24, and 48?h postoperatively (numerical rating scale 0-0), 48-h analgesic consumption, and time to first flatus passage. Results Data from 60 patients (20 per group) were analyzed. The IVL group had significantly lower pain scores at rest and cough compared to LEA or control group only at 1, 2, and 4?h postoperatively (P--.005 for all comparisons). The 48-h analgesic requirements and time to first flatus passage did not differ significantly between IVL group and LEA or control group (P--.05). Conclusions Compared with LEA-lidocaine or placebo, intravenous lidocaine offered no clinically significant benefit in terms of analgesia and bowel function.