Clinical surgery-AmericanCan intravenous lidocaine decrease postsurgical ileus and shorten hospital stay in elective bowel surgery? A pilot study and literature review
Section snippets
Materials and Methods
A randomized, double-blinded, placebo-controlled, prospective study was implemented to assess the effectiveness of systemic lidocaine versus placebo in patients receiving morphine patient-controlled analgesia (PCA) after bowel surgery. After elective bowel surgery, patients were placed on a morphine PCA pump and either normal saline placebo or lidocaine infused at 1 mg/min for 24 hours. The lidocaine infusion was discontinued 24 hours after surgery. The morphine PCA was to be continued at the
Results
Twenty-two patients underwent elective bowel surgery. Table 1 shows patient demographics. The procedures were as follows: 12 right colectomies, 2 left colectomies, 3 low anterior sigmoid resections, and 5 small-bowel resections. The populations were similar with regard to ASA scores, and none of the patients had a score >III (lidocaine 2.18 ± .18 vs control 2.00 ± .19; P = .498). The mean ages of the patients were 60 and 65 years in the lidocaine and placebo groups, respectively.
None of the
Comments
First, the results of the current study contribute to the literature showing that IV lidocaine may be safely used to combat POI. Lidocaine is an amide and a less commonly used antiarrhythmic that exerts its effects by decreasing conductance on nerve axon sodium channels. Lidocaine toxicity follows a predictable progression and can be divided into central nervous system and cardiovascular effects. At low plasma concentrations, these include numbness of the tongue and circumoral tissues. If
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2019, Operative Techniques in OrthopaedicsCitation Excerpt :This early decrease in pain is crucial for early patient mobility and satisfaction which is associated with improved outcomes and lower rates of complications, including reduced perioperative constipation. IV administration of traditional local anesthetics (such as lidocaine, bupivacaine, etc) has gained popularity amongst general surgeons due to the avoidance of the issues with narcotics and post bowel surgery ileus, and shorter hospital stays.28,29 Lumbar spine surgery also has a risk of ileus especially in cases of increased blood loss, lumbar correction, and fusion procedures.
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