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