Assessment of the Effect of Perioperative Venous Lidocaine on the Intensity of Pain and IL-6 Concentration After Laparoscopic Gastroplasty

Obesity Surgery volume 30, pages3912–3918(2020)Cite this article

Abstract

Background and Objectives

Opioids are associated with sedation and respiratory depression. The primary objective of this study was to assess pain intensity after gastric bypass with lidocaine. The secondary objective was to assess the IL-6 concentration, consumption of morphine, time to morphine request, time to extubation, and side effects.

Methods

Sixty patients aged 18 to 60 years, with ASA (American Society of Anesthesiologists) scores of 2 or 3, who underwent bariatric surgery were allocated to two groups. Patients in group 1 were administered lidocaine (1.5 mg/kg) 5 min before the induction of anesthesia, and group 2 was administered 0.9% saline solution in an equal volume. Subsequently, lidocaine (2 mg/kg/h) or 0.9% saline was infused during the entire surgical procedure. Anesthesia was performed with fentanyl (5 μg/kg), propofol, rocuronium, and sevoflurane. Postoperative patient-controlled analgesia was provided with morphine. The following were evaluated: pain intensity, IL-6, 24-h consumption of morphine, time to the morphine request, time to extubation, and adverse effects.

Results

The lidocaine group had a lower pain intensity than the saline group for up to 1 h, with no differences between groups in IL-6 and time to extubation. The lidocaine group consumed less morphine within 24 h, had a longer time until the first supplemental morphine request, and had a lower incidence of nausea.

Conclusions

Lidocaine reduced the intensity of early postoperative pain, incidence of nausea, and consumption of morphine within 24 h and increased time to the first morphine request, without reducing the plasma concentrations of IL-6.

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Acknowledgments

Thanks are due to all patients who participate in the study, to the Hemotherapy Service of the Hospital São Domingos, and to the Immunology Laboratory of the Federal University of São Paulo.

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Affiliations

  1. Universidade Federal do Maranhão, São Luís, Brazil

    Caio Marcio Barros de Oliveira, Lais Maria Gaspar Coelho, José Aparecido Valadão, Ed Carlos Rey Moura, Antônio Augusto Moura da Silva, Roclides Castro de Lima & Plinio da Cunha Leal

  2. Universidade Federal de São Paulo, Rua Botucatu 593, São Paulo, 04023-900, Brazil

    Milena Karina Coló Brunialti, Reinaldo Salomão & Rioko Kimiko Sakata

Authors
  1. Caio Marcio Barros de Oliveira
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  2. Lais Maria Gaspar Coelho
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Correspondence to Rioko Kimiko Sakata.

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de Oliveira, C.M.B., Coelho, L.M.G., Valadão, J.A. et al. Assessment of the Effect of Perioperative Venous Lidocaine on the Intensity of Pain and IL-6 Concentration After Laparoscopic Gastroplasty. OBES SURG 30, 3912–3918 (2020). https://doi.org/10.1007/s11695-020-04748-1

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Keywords

  • Lidocaine
  • Gastroplasty
  • Postoperative pain
  • Analgesia
  • Interleukin-6