Can intravenous lidocaine decrease postsurgical ileus and shorten hospital stay in elective bowel surgery? A pilot study and literature review

Am J Surg. 2009 Aug;198(2):231-6. doi: 10.1016/j.amjsurg.2008.10.015. Epub 2009 Mar 12.

Abstract

Background: This study examined whether systemic infusion of lidocaine, a local anesthetic with anti-inflammatory properties, can decrease surgical pain, length of postsurgical ileus, and hospital stay.

Methods: Twenty-two patients at a community hospital were randomized into 2 groups. Subjects were allocated to receive either lidocaine or a placebo infusion for the first 24 hours after surgery.

Results: Patients in the lidocaine group appeared to report less pain as reflected by a decrease in overall visual analogue scale pain scores 24 hours after surgery. The return of flatus after surgery was not considered significant (lidocaine 68.2 +/- 9.7 hours vs placebo 86.9 +/- 13.6 hours; P = .2802). The return of bowel movement after surgery was considered significant (lidocaine 88.3 +/- 6.08 hours vs placebo group 116 +/- 10.1 hours; P = .0286). The lidocaine group was discharged by mean day 3.76 +/- .24 versus placebo at mean day 4.93 +/- .42; P = .0277.

Conclusions: Patients in the lidocaine group had bowel movements >24 hours earlier than those in the placebo group and were discharged earlier.

Publication types

  • Randomized Controlled Trial
  • Review

MeSH terms

  • Aged
  • Analgesia, Patient-Controlled
  • Analgesics, Opioid / therapeutic use
  • Anesthetics, Local / therapeutic use*
  • Defecation
  • Double-Blind Method
  • Elective Surgical Procedures
  • Female
  • Hospitals, Community
  • Humans
  • Ileus / drug therapy*
  • Infusions, Intravenous
  • Intestines / surgery*
  • Length of Stay / statistics & numerical data*
  • Lidocaine / therapeutic use*
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Pain Measurement
  • Pain, Postoperative / prevention & control
  • Pilot Projects
  • Postoperative Complications / drug therapy*

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Lidocaine