THE USE OF LIDOCAINE INFUSION FOR ANALGESIA AND PREVENTION OF ILEUS AFTER MAJOR ABDOMINAL SURGERIES


Cite item

Full Text

Abstract

Objective. To assess the effect of infusion of lidocaine solution in patients after extensive abdominal operations. Material and methods. Were examined 42 patients with cancer of the pancreas, which is made pancreatoduodenal resections. The patients were divided into two comparable groups. Patients of the first group (n=21) before surgery injected bolus 1.5 mg/kg lidocaine, followed by infusion at a rate of 1.5 mg/kg*h during the first 24 hours after surgery. Patients of the second group (n=21) started epidural infusion of 0.2 % ropivacaine solution at a rate of 5 ml/h. The intensity of pain syndrome was evaluated on VAS at rest and during mobilization, bowel actions, the time of first flatus and first stool, the need for additional analgesics and lenght of stay in the intensive care unit. Results. The intensity of pain in the first day was significantly (p <0.05) lower in the 2nd group than in the 1st group. The bowel actions, the time of first flatus and first stool between the groups did not differ significantly. The need for additional analgesics in the 2nd group was lower than in the 1st group, 4 (19%) and 17 (80.9%) patients respectively (p<0.05). The length of stay in ICU was 4.1±1.66 bed days in patients of the first group, 3.4±1.25 bed days in patients of the second group (p<0.05). Conclusion. Perioperative intravenous lidocaine is an effective and safe method of postoperative analgesia, which by its characteristics is comparable to epidural analgesia.

About the authors

Ivan Y. Sholin

Scientific Research Institute - S.V. Ochapovsky Regional Clinic Hospital # 1

Email: scholin.i@mail.ru
the head of the Department of anesthesiology and intensive care #6. State Public Health Budget Institution “Scientific Research Institute - S.V. Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, Russian Federation 350086, Krasnodar, Russian Federation

V. A Avetisyan

Scientific Research Institute - S.V. Ochapovsky Regional Clinic Hospital # 1

350086, Krasnodar, Russian Federation

B. S Ezugbaia

Scientific Research Institute - S.V. Ochapovsky Regional Clinic Hospital # 1

350086, Krasnodar, Russian Federation

V. A Zhikharev

Scientific Research Institute - S.V. Ochapovsky Regional Clinic Hospital # 1

350086, Krasnodar, Russian Federation

V. A Koriachkin

Scientific Research Institute - S.V. Ochapovsky Regional Clinic Hospital # 1

350086, Krasnodar, Russian Federation

E. Y Felker

Scientific Research Institute - S.V. Ochapovsky Regional Clinic Hospital # 1

350086, Krasnodar, Russian Federation

References

  1. Institute of Medicine. Relieving pain in America. USA: National Academies Press, 2011.
  2. Gregory J., McGowan L. An examination of the prevalence of acute pain for hospitalised adult patients: a systematic review. J. Clin. Nurs. 2016; 25 (5-6): 583-98.
  3. Murray A.A., Wilhelm F. Retief acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors Southern African Journal of Anaesthesia and Analgesia. 2016; 22 (1): 19-24.
  4. Страшнов В.И., Забродин О.Н., Мамедов А.Д., Страшнов А.В., Корячкин В.А. Предупреждение интраоперационного стресса и его последствий. СПб: ЭЛБИ-СПб; 2015. - 160 с.
  5. Корячкин В.А., Страшнов В.И., Думпис Т.И., Ловчев А.Ю., Башар А. Клинико-экономические аспекты анестезиологии. Вестник хирургии им. И.И. Грекова. 2006; 165 (1): 86-91.
  6. Гомон Н.Л., Шлапак И.П. Мультимодальная комбинированная анестезия/анальгезия в комплексе лечения хирургических пациентов абдоминального профиля. Новости хирургии. 2014; 22 (6): 721-6.
  7. Горобец Е.С. Принципы анестезии при абдоминальных онкологических операциях. Регионарная анестезия и лечение острой боли. 2009; 3 (2): 32-42.
  8. Овечкин А.М., Беккер А.А. Внутривенная инфузия лидокаина как перспективный компонент мультимодальной анальгезии, влияющий на течение раннегопослеоперационного периода. Регионарная анестезия и лечение острой боли. 2017; 11 (2): 73-83.
  9. Eipe N., Gupta S., Penning J. Intravenous lidocaine for acute pain: an evidence-based clinical update. BJA Education. 2016; 16 (9): 292-8.
  10. Kranke P. Jokinen J. Pace N.L., Schnabel A., Hollmann M.W., Hahnenkamp K., Eberhart L.H., Poepping D.M., Weibel S. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. Cochrane Database Syst. Rev. 2015; 16 (7): CD009642.
  11. Wongyingsinn M., Baldini G., Charlebois P., Liberman S., Stein B., Carli F. Intravenous lidocaine versus thoracic epidural analgesia: a randomized controlled trial in patients undergoing laparoscopic colorectal surgery using an enhanced recovery program. Reg. Anesth. Pain Med. 2011; 36 (3): 241-8.
  12. Swenson B.R., Gottschalk A., Wells L.T., Rowlingson J.C., Thompson P.W., Barclay M. et al. Intravenous lidocaine is as effective as epidural bupivacaine in reducing ileus duration, hospital stay, and pain after open colon resection: a randomized clinical trial. Regional Anesthesia & Pain Medicine. 2010; 35: 370-6.
  13. Lauretti G. Mechanisms of analgesia of intravenous lidocaine. Rev. Bras. Anestesiol. 2008; 58 (3): 280-6.
  14. Abelson K., Hoglund A. Intravenously administered lidocaine in therapeutic doses increases the intraspinal release of acetylcholine in rats. Neurosci. Lett. 2002; 317: 93-6.
  15. Cohen S., Mao J. Is the analgesic effect of systemic lidocaine mediated through opioid receptors? Acta Anaesthesiol. Scand. 2003; 47: 910-1.
  16. Nordstrom H., Stange K. Plasma lidocaine levels and risks after liposuction with tumescent anaesthesia. Acta Anaesthesiol. Scand. 2005; 49: 1487-90.
  17. Sharma S., Rajagopal M.R., Palat G., Singh C., Haji A.G., Jain D. A phase II pilot study to evaluate use of intravenous lidocaine for opioid-refractory pain in cancer patients. J. Pain Symptom Manage. 2009; 37 (1): 85-93.
  18. Бойко В. В., Тимченко Н. В., Бойчук И. П., Белявский А. В. Факторы риска возникновения послеоперационного пареза кишечника у пациентов, на толстой кишке. Харківська хірургічна школа. 2014; 2 (65): 47-50.
  19. Соловьев И. А. Колунов А. В. Послеоперационный парез кишечника: проблема абдоминальной хирургии Журнал им. Н.И. Пирогова. 2013; 11: 46-52.
  20. Guay J., Nishimori M., Kopp S. Epidural local anaesthetics versus opioid-based analgesic regimens for postoperative gastrointestinal paralysis, vomiting and pain after abdominal surgery. Cochrane Database Syst. Rev. 2016; 16 (7): CD001893.
  21. Marret E., Rolin M., Beaussier M., Bonnet F. Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br. J. Surg. 2008; 95 (11): 1331-8.
  22. Sun Y., Li T., Wang N., Yun Y., Gan T.J. Perioperative systemic lidocaine for postoperative analgesia and recovery after abdominal surgery: a meta-analysis of randomized controlled trials. Dis. Colon. Rectum. 2012; 55 (11): 1183-94.

Copyright (c) 2018 Eco-Vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies