As anesthetists we face the challenge of providing a safe, comfortable and speedy recovery to our patients. Narcotics improve analgesia at the expense of nausea and speed of recovery. The use of non-opioid drugs to supplement and reduce the amout of narcotic administered should, in theory, provide a comfortable and speedy recovery. In this study, the use of systeminc lidocaine was evaluated.
A study published in Anesth Analg 2012, 115(2) 262-7 by De Oliveira GS Jr et al, (Systemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery.) examined the use of systemic lidocaine in 63 female patients undergoing laparoscopic surgery. Following induction, patients were given a loading dose of lidocaine 1.5 mg/kg followed by an infusion of 2mg/kg/hour for the duration of the case.
Assessment following surgery found that those receiving lidocaine had a decided improvement in the quality of postoperative recovery. Patients in the Lidocaine group had higher scores in physical independence and comfort with a 23% improvement in global recovery scores. There was significantly less opioid used in the lidocaine group. Also, those receiving lidocaine had a 26 min reduction in time to hospital discharge. Overall, in an outpatient setting, systemic lidocaine offered a definite advantage.
Click here to read an abstract of the original article.
A similar study by US Navy CRNAs (Grady et al, AANA Journal August 1012) followed a similar protocol. Although not statistically significant, the authors found that those receiving the intravenous lidocaine reported greater satisfaction and comfort than those in the control group. (P=0.08) Possibly with a larger N this study would also have reached statistical significance
Click here to read the article in the AANA Journal (page 282)