A Randomized Controlled Trial Comparing Intravenous Lidocaine Infusion With Thoracic Epidural for Perioperative Analgesia and Quality of Recovery After Surgery in Laparoscopic Left-Sided Colon and Sphincter-Sparing Rectal Resection Surgery.
colon and rectal surgery
enhanced recovery
epidural
intravenous lidocaine infusion
laparoscopy
length of hospital stay
perioperative analgesia
quality of recovery
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
accepted:
02
04
2022
entrez:
5
5
2022
pubmed:
6
5
2022
medline:
6
5
2022
Statut:
epublish
Résumé
Background Protocols for Enhanced Recovery after Surgery (ERAS) have been constantly evolving, and the best method of managing perioperative pain, especially in laparoscopic surgeries, is still debatable. The primary goal of these protocols is to steer toward opioid-sparing analgesia. Intravenous lidocaine, which has both analgesic and anti-inflammatory properties, may improve the overall recovery of patients. Objectives The aim of this randomized controlled trial was to compare the efficacy of intravenous lidocaine infusion (IVL) with thoracic epidural analgesia (TEA) in the management of perioperative pain and recovery in the laparoscopic left-sided colon and sphincter-sparing rectal surgery. Methods In this study, 37 patients were randomized to either the IVL group or the TEA group. IVL infusion was started before the surgical incision and stopped 30 minutes after transferring the patient to the postanesthesia care unit (PACU). Postoperative pain scores, opioid consumption, rescue analgesic doses, quality of recovery scores, time to discharge, and adverse events were recorded prospectively. Data were analyzed using two independent sample t-test and paired t-test, with p < 0.05 taken as statistically significant. Results The mean difference of overall NRS (numerical rating scale) pain scores in the ward was significantly higher in the IVL group as compared to the TEA group, which was 3.58 (2.29) vs 2.23 1.95) (p < 0.001). The IVL group required more mean rescue opioid boluses than the TEA group, which was 11.36 (8.684) vs 5.96 (6.215) (p < 0.001). However, both IVL and TEA groups had similar pain scores intraoperatively and in the PACU. Conclusions TEA provides better analgesia and decreased opioid requirements compared to intravenous lidocaine during the 24-hour period in the ward after laparoscopic left-sided colon and sphincter-sparing rectal surgery, although there was no difference in the quality of recovery between IVL and TEA groups.
Identifiants
pubmed: 35509732
doi: 10.7759/cureus.23758
pmc: PMC9059900
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e23758Informations de copyright
Copyright © 2022, Jayaprabhu et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Br J Surg. 2006 Aug;93(8):921-8
pubmed: 16845692
Perioper Med (Lond). 2019 Feb 26;8:1
pubmed: 30858969
J Endourol. 2005 Dec;19(10):1165-9
pubmed: 16359206
Br J Anaesth. 2018 Jan;120(1):28-36
pubmed: 29397134
J Gastrointest Surg. 2014 Dec;18(12):2155-62
pubmed: 25245767
Anesth Analg. 1998 Feb;86(2):235-9
pubmed: 9459225
Ann Surg. 2007 Aug;246(2):192-200
pubmed: 17667496
Reg Anesth Pain Med. 2001 Mar-Apr;26(2):111-7
pubmed: 11251133
World J Surg. 2015 Sep;39(9):2220-34
pubmed: 26044546
Surg Endosc. 2013 Jul;27(7):2581-91
pubmed: 23389071
Br J Anaesth. 2008 Dec;101(6):832-40
pubmed: 18945716
Ann Surg. 2006 Jan;243(1):41-6
pubmed: 16371735
Korean J Anesthesiol. 2018 Feb;71(1):57-65
pubmed: 29441176
Cochrane Database Syst Rev. 2018 Jun 04;6:CD009642
pubmed: 29864216
Anesthesiology. 2013 Jun;118(6):1332-40
pubmed: 23411725
Tech Coloproctol. 2014 Apr;18(4):373-80
pubmed: 24030782
World J Surg. 2019 Mar;43(3):659-695
pubmed: 30426190
Surg Res Pract. 2016;2016:7543684
pubmed: 27642630
Reg Anesth Pain Med. 2011 May-Jun;36(3):241-8
pubmed: 21519309
JAMA Surg. 2014 Feb;149(2):130-6
pubmed: 24336894
Reg Anesth Pain Med. 2016 Jan-Feb;41(1):28-36
pubmed: 26650426
Colorectal Dis. 2013 Feb;15(2):146-55
pubmed: 23350836
J Clin Anesth. 2016 Feb;28:95-104
pubmed: 26342631
Lancet. 2003 Dec 6;362(9399):1921-8
pubmed: 14667752
Br J Surg. 2011 Aug;98(8):1068-78
pubmed: 21590762
Anesth Analg. 2004 Apr;98(4):1050-1055
pubmed: 15041597
Br J Anaesth. 2006 Nov;97(5):640-6
pubmed: 16952918
Anesthesiology. 2000 Sep;93(3):858-75
pubmed: 10969322
Cochrane Database Syst Rev. 2015 Jul 16;(7):CD009642
pubmed: 26184397
Br J Anaesth. 2005 Jun;94(6):710-4
pubmed: 15833778