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

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

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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Ethical Approval

NAC 5/30-11-2011, Chairman Dr. A. Melidonis, IRB of Tzaneion General Hospital of Piraeus.

Conflict of Interest

None declared

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Authors and Affiliations

  1. First Department of Anesthesiology, Aretaieion Hospital, University of Athens School of Medicine, 76 Vass. Sophias Av., 11528, Athens, Greece

    Chryssoula Staikou & Eriphili Argyra

  2. Department of Anesthesiology, Tzaneion General Hospital, Zanni & 1 Afentouli Strs, 18536, Piraeus, Greece

    Alexandra Avramidou

  3. Second Department of Surgery, Tzaneion General Hospital, Zanni & 1 Afentouli Strs, 18536, Piraeus, Greece

    Georgios D. Ayiomamitis

  4. Tzaneion General Hospital, Zanni & 1 Afentouli Strs, 18536, Piraeus, Greece

    Spyros Vrakas

Authors
  1. Chryssoula Staikou
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  2. Alexandra Avramidou
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  3. Georgios D. Ayiomamitis
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  4. Spyros Vrakas
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  5. Eriphili Argyra
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Corresponding author

Correspondence to Chryssoula Staikou.

Additional information

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

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Staikou, C., Avramidou, A., Ayiomamitis, G.D. et al. Effects of Intravenous Versus Epidural Lidocaine Infusion on Pain Intensity and Bowel Function After Major Large Bowel Surgery: a Double-Blind Randomized Controlled Trial. J Gastrointest Surg 18, 2155–2162 (2014). https://doi.org/10.1007/s11605-014-2659-1

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  • DOI: https://doi.org/10.1007/s11605-014-2659-1

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