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Systemic Lidocaine to Improve Quality of Recovery after Laparoscopic Bariatric Surgery: A Randomized Double-Blinded Placebo-Controlled Trial

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Abstract

Background

Few multimodal strategies to minimize postoperative pain and improve recovery have been examined in morbidly obese patients undergoing laparoscopic bariatric surgery. The main objective of this study was to evaluate the effect of systemic intraoperative lidocaine on postoperative quality of recovery when compared to saline.

Methods

The study was a prospective randomized, double-blinded placebo-controlled clinical trial. Subjects undergoing laparoscopic bariatric surgery were randomized to receive lidocaine (1.5 mg/kg bolus followed by a 2 mg/kg/h infusion until the end of the surgical procedure) or the same volume of saline. The primary outcome was the quality of recovery 40 questionnaire at 24 h after surgery.

Results

Fifty-one subjects were recruited and 50 completed the study. The global QoR-40 scores at 24 h were greater in the lidocaine group median (IQR) of 165 (151 to 170) compared to the saline group, median (IQR) of 146 (130 to 169), P = 0.01. Total 24 h opioid consumption was lower in the lidocaine group, median (IQR) of 26 (19 to 46) mg IV morphine equivalents compared to the saline group, median (IQR) of 36 (24 to 65) mg IV morphine equivalents, P = 0.03. Linear regression demonstrated an inverse relationship between the total 24 h opioid consumption (IV morphine equivalents) and 24 h postoperative quality of recovery (P < 0.0001).

Conclusions

Systemic lidocaine improves postoperative quality of recovery in patients undergoing laparoscopic bariatric surgery. Patients who received lidocaine had a lower opioid consumption which translated to a better quality of recovery.

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Acknowledgments

The authors would like to thank the Department of Anesthesiology, Northwestern University.

Conflict of Interest

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Authors and Affiliations

  1. Department of Anesthesiology, Northwestern University, Chicago, IL, USA

    Gildasio S. De Oliveira Jr., Kenyon Duncan, Paul Fitzgerald, Antoun Nader, Robert W. Gould & Robert J. McCarthy

  2. Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, 241 east Huron St. F5-704, Chicago, IL, USA

    Gildasio S. De Oliveira Jr.

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  1. Gildasio S. De Oliveira Jr.
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  2. Kenyon Duncan
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  3. Paul Fitzgerald
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Correspondence to Gildasio S. De Oliveira Jr..

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De Oliveira, G.S., Duncan, K., Fitzgerald, P. et al. Systemic Lidocaine to Improve Quality of Recovery after Laparoscopic Bariatric Surgery: A Randomized Double-Blinded Placebo-Controlled Trial. OBES SURG 24, 212–218 (2014). https://doi.org/10.1007/s11695-013-1077-x

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  • DOI: https://doi.org/10.1007/s11695-013-1077-x

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