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A Comparative Study to Evaluate the Efficacy of Three Different Doses of Intraoperative Infusion
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Background: Surgical stress and pain elicit a consistent and well-defined metabolic response, involving release of neuroendocrine hormones and cytokines, which leads to a myriad of detrimental effects. Lidocaine is a local anesthetic and antiarrhythmic which has anti-inflammatory, analgesic and anti-hyperalgesic properties. There are studies comparing differentt doses of infusion for varying periods of time, our study was aimed to evaluate the efficacy of intraoperative infusion of three different doses of intravenous Lidocaine in patients undergoing Laparoscopic cholecystectomy. Methods: Forty-eight inpatients were divided into 3 groups of 16 each. All the groups received intravenous lidocaine infusion of 1.5 mg/kg bolus over 10 min, 30 min before the skin incision followed by 1 mg/kg/hr in Group A, 2 mg/kg/hr in Group B and 3 mg/kg/hr in Group C infusion throughout the surgery and continued for 1 hour after the skin closure. The outcome measures are the time at which first visual analogue scale (VAS) was more than 4 requiring rescue analgesia of Inj Tramadol, total number of doses and side effects of lignocaine in 24 hours of postoperative period. Results: Onset of breakthrough pain (VAS>4) was significantly prolonged in Group C than Group A and B. Time for first rescue analgesia was significantly prolonged in Group C than Group A and Group B. Overall Analgesic consumption was significantly lower in Group C than other groups. Conclusion: Intraoperative infusion of intravenous preservative free Lidocaine at 3 mg/kg/hour is more efficient than 2 mg/kg/hour and 1 mg/kg/hour in controlling postoperative pain and reduces the requirement of postoperative analgesics.
Perspectives
Background: Surgical stress and pain elicit a consistent and well-defined metabolic response, involving release of neuroendocrine hormones and cytokines, which leads to a myriad of detrimental effects. Lidocaine is a local anesthetic and antiarrhythmic which has anti-inflammatory, analgesic and anti-hyperalgesic properties. There are studies comparing differentt doses of infusion for varying periods of time, our study was aimed to evaluate the efficacy of intraoperative infusion of three different doses of intravenous Lidocaine in patients undergoing Laparoscopic cholecystectomy. Methods: Forty-eight inpatients were divided into 3 groups of 16 each. All the groups received intravenous lidocaine infusion of 1.5 mg/kg bolus over 10 min, 30 min before the skin incision followed by 1 mg/kg/hr in Group A, 2 mg/kg/hr in Group B and 3 mg/kg/hr in Group C infusion throughout the surgery and continued for 1 hour after the skin closure. The outcome measures are the time at which first visual analogue scale (VAS) was more than 4 requiring rescue analgesia of Inj Tramadol, total number of doses and side effects of lignocaine in 24 hours of postoperative period. Results: Onset of breakthrough pain (VAS>4) was significantly prolonged in Group C than Group A and B. Time for first rescue analgesia was significantly prolonged in Group C than Group A and Group B. Overall Analgesic consumption was significantly lower in Group C than other groups. Conclusion: Intraoperative infusion of intravenous preservative free Lidocaine at 3 mg/kg/hour is more efficient than 2 mg/kg/hour and 1 mg/kg/hour in controlling postoperative pain and reduces the requirement of postoperative analgesics.
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This page is a summary of: A Comparative Study to Evaluate the Efficacy of three Different Doses of Intraoperative Infusion of Intravenous Preservative Free Lidocaine in Patients Undergoing Laparoscopic Cholecystectomy, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6519.53.
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