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01.12.2014 | Original Article | Ausgabe 12/2014

Journal of Gastrointestinal Surgery 12/2014

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

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 12/2014
Autoren:
Chryssoula Staikou, Alexandra Avramidou, Georgios D. Ayiomamitis, Spyros Vrakas, Eriphili Argyra
Wichtige Hinweise

Authors’ Contributions

Study conception and design: A. Avramidou, G. Ayiomamitis, E. Argyra
Acquisition of data: A. Avramidou, G. Ayiomamitis, S. Vrakas
Analysis and interpretation of data: S. Vrakas, C. Staikou
Drafting of manuscript: A. Avramidou, C. Staikou
Critical revision of manuscript: C. Staikou, E. Argyra

Abstract

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 0–10), 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 < 0.005 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 > 0.05).

Conclusions

Compared with LEA-lidocaine or placebo, intravenous lidocaine offered no clinically significant benefit in terms of analgesia and bowel function.

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