Abstract
Background
Methods
Results
Acknowledgments
References
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Fig. 2
Postoperative NRS pain scores (0–10). Data are presented as median (IQR). None of the differences in median NRS scores reached clinical significance at any time during the first 72 postoperative hours (P > 0.05).
![kjae-71-57-g002](/upload/SynapseXML/0011kja/thumb/kjae-71-57-g002.jpg)
Fig. 3
Cumulative postoperative opioid use (µg fentanyl). Data are presented as median (IQR). All measured time points from 12 to 72 postoperative hours showed a statistically significant reduction in opioid use (P < 0.05).
![kjae-71-57-g003](/upload/SynapseXML/0011kja/thumb/kjae-71-57-g003.jpg)
Table 1
Patient Characteristics and Clinical Data
![kjae-71-57-i001](/upload/SynapseXML/0011kja/thumb/kjae-71-57-i001.jpg)
Table 2
Time Outcomes between Randomized Arms
![kjae-71-57-i002](/upload/SynapseXML/0011kja/thumb/kjae-71-57-i002.jpg)
Table 3
Profiles of 16 Trials Investigating i.v. Lidocaine in Open Abdominal Surgery [4]
![kjae-71-57-i003](/upload/SynapseXML/0011kja/thumb/kjae-71-57-i003.jpg)
Clinical trial | No. of patients (lidocaine/control) | i.v. Lidocaine intervention | Surgery type | Flatus return (h) | Bowel movement return (h) | Hospital discharge time (days) | Cumulative 48-h opioid consumption (mg) | Pain scores |
---|---|---|---|---|---|---|---|---|
Baral et al. [16], 2010 | 30/30 | Bolus 1.5 mg/kg 30 min before surgery followed by infusion (1.5 mg/kg/h) for 1 h postoperatively | Open upper abdominal | NM | NM | NM | NM | VAS reduced at 0, 30 min; increased 60 min* |
No difference at or after 60 min‡ | ||||||||
Bryson et al. [17], 2010 | 44/46 | Bolus (1.5 mg/kg) before induction followed by infusion (3 mg/kg/h) intraoperatively | Abdominal hysterectomy | NM | NM | 10 vs. 15 patients discharged on POD 2‡ | 66.50 (38.50) vs. 71.70 (33.30)‡ | NRS scores at PACU, 6, 24, 48 h‡ |
Harvey et al. [7], 2009 | 11/11 | After skin closure, infusion of 60 mg/h for 24 h postoperatively | Open colorectal | 68.20 (30.51) vs. 86.90 (45.11)* | 88.30 (20.17) vs. 116.20 (30.50)‡ | 3.76 (0.80) vs. 4.93 (1.39)* | 47.20 (27.20) vs. 39.70 (17.58)‡ | VAS scores at 6, 18, 24 h‡ |
Yardeni et al. [18], 2009 | 30/30 | Bolus (1.5 mg/kg) 20 min before surgical incision followed by infusion (1.5 mg/kg/h) up to the end of surgery | Transabdominal hysterectomy | NM | NM | NM | NM | VAS reduced at 4, 8 h* |
No difference at 12, 24, 48, 72 h‡ | ||||||||
Herroeder et al. [6], 2007 | 31/29 | Bolus (1.5 mg/kg) before induction followed by infusion (2 mg/min) until 4 h postoperatively | Open colorectal | 52.57 (20.57) vs. 60.57 (28.57)* | 67.89 (26.84) vs. 83.68 (34.42)* | 7 (6–8) vs. 8 (7–11)* Median (IQR) | 70.20 (67.93) vs. 70.93 (53.60)‡ | VAS scores from 2 to 156 h‡ |
Kuo et al. [10], 2006 | 20/20 | Bolus (2 mg/kg) 30 min before surgery followed by infusion (3 mg/kg/h) until the end of surgery | Open colorectal | 60.20 (5.80) vs. 71.70 (4.70)* | NM | 6.90 (0.80) vs. 7.10 (0.80)‡ | NM | VAS reduced at 1, 2 h* |
No difference at 4, 24, 48, 72 h‡ | ||||||||
Koppert et al. [15], 2004 | 20/20 | Bolus (1.5 mg/kg in 10 min) 30 min before skin incision followed by infusion (1.5 mg/kg/h) for 1 h after skin closure | Open abdominal | NM | NM | 12.80 (4.20) vs. 14.20 (3.10)‡ | 103.10 (72.00) vs. 159.00 (73.30)* | NRS scores from 0–72 h‡ |
Groudine et al. [5], 1998 | 20/20 | Bolus (1.5 mg/kg) before induction followed by infusion (3 mg/min (BW >70 kg) or 2 mg/min (BW <70 kg) for 60 min after skin closure | Radical retropubic prostatectomy | 28.50 (13.40) vs. 42.10 (16.00)* | 61.80 (13.20) vs. 73.90 (16.30)* | 4.00 (0.69) vs. 5.10 (2.80)‡ | 8.67 (11.81) vs. 14.18 (21.07)‡ | PSI 4.67 (3.94) vs. 13.25 (7.65)* |
Chia et al. [19], 1998 | 25/25 | Postoperative PCA: morphine (2.5 mg/ml) plus lidocaine (3.2 mg/ml), 5 ml bolus with 50 ml in 4 h limit | Open abdominal | NM | NM | NM | 45.30 (53.50) vs. 32.90 (56.50)‡ | VAS scores from 0–72 h‡ |
Cepeda et al. [20], 1996 | 95/105 | Postoperative PCA 10 mg/ml + morphine (1 mg/ml) (n = 44); PCA 20 mg/ml + morphine (1 mg/ml) for PCA (n = 51) | Open abdominal | NM | NM | NM | 35.10 (16.56) vs. 36.72 (19.08)‡ | VAS scores from 15 min–36 h‡ |
De Kock et al. [21], 1994 | 25/25 | Three boluses (2 mg/kg) before incision, at incision, and during surgery. Postoperative PCA: morphine (1.2 mg) + clonidine (15.0 µg) + lidocaine (23 mg) per request | Left colon resection | NM | NM | NM | NM | NM |
Rimback et al. [13], 1990 | 15/15 | Bolus (100 mg) 30 min before anesthesia followed by infusion (3 mg/min) for 24 h postoperatively | Open cholecystectomy | 37.71 (9.95) vs. 42.00 (19.91)‡ | 73.71 (39.81) vs. 92.57 (33.19)‡ | NM | 13.87 (11.88) vs. 28.27 (20.14)* | NM |
Wallin et al. [22], 1987 | 18/20 | Bolus (100 mg) 30 min before the end of surgery followed by infusion 2 mg/min for 24 h postoperatively | Open cholecystectomy | NM | NM | NM | 14.67 (14.14) vs. 27.73 (23.25)* | NM |
Birch et al. [23], 1987 | 9/9 | Bolus (1.5 mg/kg) at the first request for pain relief after surgery followed by infusion (2 mg/kg/h) for 2 h postoperatively | Transabdominal hysterectomy | NM | NM | NM | 12.21 (6.30) vs. 15.70 (6.00)‡ | VAS scores from 0–120 min‡ |
Cassuto et al. [14], 1985 | 10/10 | Bolus (10 mg) 30 min before surgery followed by infusion (2 mg/kg/h) for 24 h postoperatively | Open cholecystectomy | NM | NM | NM | 7.42 (7.13) vs. 29.03 (24.48)* | Cumulative 24 h VAS 9.4 (2.0) vs. 29.3 (2.5)* |
Ho et al., 2017 | 28/29 | Bolus (1.5 mg/kg) at induction followed by infusion (1 mg/kg/h) for 48 h | Open colorectal | 64.7 (38.5) vs. 70.0 (31.2)‡ | 80.1 (42.2) vs. 82.5 (40.4)‡ | 9 (8–13) vs. 11 (9–14)‡ Median (IQR) | 135 (65–294) vs. 240 (170–414)* Median (IQR) | NRS scores from 15 min to 72 h‡ |
Comparative data are presented as i.v. lidocaine vs. control groups; time to bowel function return and hospital discharge are expressed as mean (SD) unless otherwise specified; opioid use (mg morphine equivalent) [24] is expressed as mean (SD) unless otherwise specified; pain score measurements are expressed as postoperative time intervals comparing lidocaine to control groups. *P < 0.05; ‡P > 0.05. BW: body weight, i.v.: intravenous, NM: not measured, NRS: numerical rating scale, PACU: post-anesthesia care unit, PCA: patient-controlled analgesia, POD: postoperative day, PSI: pain score index, VAS: Visual analog scale.