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To examine the effectiveness of Lidocaine intravenous (IV) administration concerning post-operative morphine intake and pain levels following a video-assisted thoracoscopic surgery (VATS) when used peri-operatively.
Post-thoracic surgery, pain management persists as a challenge, with Lidocaine infusion displaying promise within multimodal analgesia, particularly for patients with contraindications to other analgesics.
To examine the effectiveness of Lidocaine intravenous (IV) administration concerning post-operative morphine intake and pain levels following a video-assisted thoracoscopic surgery (VATS) when used peri-operatively.
This trial employed a double-blind, placebo-controlled design in which the participants scheduled for VATS lasting up to 90 minutes were randomly assigned in an intention-to-treat fashion.
They were administered either Lidocaine IV or a placebo, delivered as a bolus of 1.5 mg/kg 30 minutes before the surgical incision, followed by a continuous infusion of 3.0 mg/kg in an hour until 2 hours after the wound closure.
Pain levels and morphine usage were assessed during resting periods and episodes of coughing at intervals of 1 hour, 2 hours, 4 hours, 8 hours, 16 hours, 24 hours and 48 hours after closure. Additional assessments were made at 14, 90, and 180 days post-operation.
The study encompassed 28 individuals in the Lidocaine group and 24 in the placebo group with comparable patient characteristics and pre-surgery pain scores. Notably, within 24 hours after wound closure, patients who received Lidocaine experienced significant pain relief when coughing than those in the placebo group (4.60±1.64 versus 5.52±1.65; P=0.02).
However, the difference in morphine consumption between the Lidocaine and placebo groups was not statistically significant (18.22±12.87 vs. 21.26±9.39 mg; P=0.26). Secondary outcomes did not reveal any significant variances between the two groups.
Perioperative Lidocaine IV reduces pain scores after VATS. The positive clinical impacts are constrained.Top of Form
Journal of Thoracic Disease
Perioperative intravenous Lidocaine in thoracoscopic surgery for improved postoperative pain control: a randomized, placebo-controlled, double-blind, superiority trial
Aljaz Hojski et al.
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