,
Oyewole Ezeikel,
Agu Edith Ebere,
Adeyemi Osebequin William,
Achi Joseph Olung
Introduction: Major gynaecological surgeries are associated with considerable postoperative pain, which remains a challenge for many practitioners. Multimodal forms of analgesia significantly reduce the requirement of opioids for pain management. Despite its local anaesthetic effects, lidocaine infusion improves postoperative pain and morphine consumption following gynaecological surgeries. Materials and methods: Sixty patients were assigned randomly into 2 groups (A and B) with 30 patients per group. Group A received intravenous lidocaine 1.5 mg/kg at induction via a bolus injection and 1.5 mg/kg/hr in normal saline infusion from onset of surgery to the end of surgery, while the control group (Group B) received equal volume of normal saline at the same timelines. Pain scores were assessed postoperatively using the numerical rating scale and the cumulative morphine consumed postoperatively were also measured. Results: The mean pain scores were significantly higher in the Saline Group than in the Lidocaine group. The cumulative morphine consumption after 48 hours was significantly reduced in the study group 4.87 ± 1.80 mg vs 14.13 ± 4.10 mg (P<0.0001). Conclusion: The administration of a bolus dose (1.5 mg/kg) of intravenous lidocaine at induction and a continuous intravenous infusion of 1.5 mg/kg/hr from onset of surgery till skin closure reduced the postoperative pain intensity and morphine consumption in patients undergoing major gynaecological surgeries under general anaesthesia.
| Published in | Journal of Gynecology and Obstetrics (Volume 12, Issue 6) |
| DOI | 10.11648/j.jgo.20241206.13 |
| Page(s) | 140-149 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Lidocaine, Morphine, Pain, Gynaecological Surgeries, General Anaesthesia
| [1] | Ogboli-Nwasor E, Sule ST, Yusufu LMD. Pattern of Postoperative pain management among adult surgical patients in a low-resource setting. J Pain Res. 2012; 5: 117-120. |
| [2] | Weibel S, Jokinen J, Pace NL, Schnabel A, Hollman MW, Hahnankamp K, et al. Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis. Br J Anaesth. 2016; 116: 770-783. |
| [3] | Yardeni IZ, Beilin B, Mayburd E, Levinson Y, Bessler H. The Effect of Perioperative Intravenous Lidocaine on Postoperative Pain and Immune function. Anesth Analg. 2009; 109: 1464-1469. |
| [4] | Duriex M, Ford J, Expanding Your Anaesthetic technique: An overview on the efficacy of using Lidocaine infusion as part of a balanced anaesthetic. Update Anaesthesia. 2014; 29: 24-27. |
| [5] | Shady NW, Hassan AF, Hany FS. Preemptive use of adjunctive IV lidocaine for enhanced recovery after abdominal hysterectomy for overweight and obese women: a prospective, randomized, double-blind, placebo-controlled study. Int J Reprod Contracept Obstet Gynecol. 2021; 10(3): 1095-1101. |
| [6] | Ahsan RS, Muhammad S, Muhammad A. Low dose perioperative lidocaine infusion for postoperative pain in open cholecystectomy. JRMC; 2017: 21(2): 153-156. |
| [7] | Hika A, Aberra B, Azanaw M, Admasu W, Bahrey D. Effectiveness of Intra-operative Intravenous Lidocaine Infusion as Part of Postoperative Analgesia for Patients Undergoing Abdominal Surgery under General Anesthesia in Addis Ababa Hospitals, Ethiopia 2018: Observational Cohort study. J Anesth Clin Res. 11: 954. |
| [8] | Oliveira CMB de, Sakata RK, Slullitel A, Salomão R, Lanchote VL, Issy AM. Effect of intraoperative intravenous lidocaine on pain and plasma interleukin-6 in patients undergoing hysterectomy. Rev Bras Anestesiol. 2015; 65: 92–98. |
| [9] | Wuethrich PY, Romero J, Burkhard FC, Curatolo M. No benefit from perioperative intravenous lidocaine in laparoscopic renal surgery. Eur J Anaesthesiol 2012; 29(11): 537-543. |
| [10] | Hayden P, Cowman S. Anaesthesia for laparoscopic surgery. BJA 2011; 11(5): 177-180. |
| [11] | Aubrun F, Mazoit J-X, Riou B. Postoperative intravenous morphine titration. Br J Anaesth 2012; 108(2): 193-201. |
| [12] | Tauzin-Fin P, Bernard O, Sesay M, et al. Benefits of intravenous lidocaine on post-operative pain and acute rehabilitation after laparoscopic nephrectomy. J Anaesthesiol clin pharmacol. 2014; 30: 366-372. |
| [13] | Ghimire A, Subedi A, Bhattarai B, Sah BP. The effect of intraoperative lidocaine infusion on opioid consumption and pain after totally extraperitoneal laparoscopic inguinal hernioplasty: a randomized controlled trial. BMC Anesthesiol. 2020; 20(1): 137. |
| [14] | Koshyari HS, Asthana V, Agrawal S. Evaluation of lignocaine infusion on recovery profile, quality of recovery, and postoperative analgesia in patients undergoing total abdominal hysterectomy. J Anaesthesiol Clin Pharmacol. 2019; 35(4): 528-532. |
| [15] | Maab H, Mustafa F, Arshad Ali S. Anti-inflammatory aspects of Lidocaine: a neglected therapeutic stance for COVID-19. Heart Lung. 2020; 49(6): 877-878. |
| [16] | Henning H, Markus WH, Markus FS, Philipp L, Timo B, Tobias P, Robert W. Molecular mechanisms of action of systemic lidocaine in acute and chronic pain: a narrative review. 2019; Br J Anaesth, 123(3), 335-349. |
| [17] | Daykin H. The efficacy and safety of intravenous lidocaine for analgesia in the older adult: a literature review. Br J Pain. 2017; 11(1): 23-31. |
| [18] | Shabnum T, Ali Z, Naqash IA, Mir AH, Azhar K, Zahoor SA, Mir AW. Effects of Lignocaine Administered Intravenously or Intratracheally on Airway and Hemodynamic Responses during Emergence and Extubation in Patients Undergoing Elective Craniotomies in Supine Position. Anesth Essays Res. 2017; 11(1): 216-222. |
| [19] | Hu S, Li Y, Wang S, Xu S, Ju X, Ma L. Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery. BMC Anesthesiol 2019; 19: 66. |
| [20] | Shruti J, Rashid MK. Effect of perioperative intravenous infusion of lignocaine on haemodynamic responses to intubation, extubation and postoperative analgesia. 2015; 59(6): 342-347. |
| [21] | Lauretti GR. Mechanisms of analgesia of intravenous lidocaine. Rev Bras Anestesiol. 2008; 58(3): 280-286. |
| [22] | Yon JH, Choi GJ, Kang H, Park JM, Yang HS. Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal gastrectomy: A prospective, randomized, double-blind, placebo-controlled study. Can J Surg. 2014; 57: 175–182. |
| [23] | Choi SJ, Kim MH, Jeong HY, Lee JJ. Effect of intraoperative lidocaine on anesthetic consumption, and bowel function, pain intensity, analgesic consumption and hospital stay after breast surgery. Korean J Anesthesiol. 2012; 62: 429–434. |
| [24] | Eipe N, Gupta S, Penning J. Intravenous lidocaine for acute pain: an evidence-based clinical update. bjaed. 2016; 16: 292–298. |
| [25] | McKay A, Gottschalk A, Ploppa A, Durieux ME, Groves DS. Systemic lidocaine decreased the perioperative opioid analgesic requirements but failed to reduce discharge time after ambulatory surgery. Anesth Analg. 2009; 109: 1805–1808. |
| [26] | Lauren K. Dunn, Marcel E. Durieux; Perioperative Use of Intravenous Lidocaine. Anesthesiology 2017; 126: 729–737. |
| [27] | Jonathan V; Situations Where Intravenous Lidocaine Should Not Be Used as an Analgesic Adjunct?. Anesthesiology 2017; 127: 1038. |
| [28] | Ok SH, Hong JM, Lee SH, Sohn JT. Lipid Emulsion for Treating Local Anesthetic Systemic Toxicity. Int J Med Sci. 2018 May 14; 15(7): 713-722. |
| [29] | Glowacki D. Effective pain management and improvement in patients' outcomes and satisfaction. Critical Care Nurse. 2015; 35: 33-43. Glowacki D. Effective pain management and improvement in patients' outcomes and satisfaction. Critical Care Nurse. 2015; 35: 33-43. |
| [30] | Grady P, Clark N, Lenahan J, Oudekerk C, Hawkins R, Nezat G, Pellegrini JE. Effect of intraoperative intravenous lidocaine on postoperative pain and return of bowel function after laparoscopic abdominal gynecologic procedures. AANA J. 2012; 80(4): 282-288. |
| [31] | Myles P S, Williams D L, Hendrata M, Anderson H, Weeks A M. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10 811 patients. Br J Anaesth 2000; 84: 6-10. |
| [32] | Benwu, KM, Gebremedhin HG. A prospective study on elective surgical inpatient satisfaction with perioperative anaesthesia service at Ayder comprehensive specialized hospital, Mekelle, Ethiopia. BMC Anesthesiol 2019; 19: 46. |
| [33] | Yosef BB, Girmay FL, Demeke YF, Yophtahe WB, Henos EA. Assessment of patient’s satisfaction and associated factors regardeing postoperative pain management at the University of Gondar compressive specialized hospital, Northwest Ethiopia. Pain Res Manag 2020: 8834807. |
APA Style
Uchechukwu, A. N., Ezeikel, O., Ebere, A. E., William, A. O., Olung, A. J. (2024). The Effects of Intra-Operative Lidocaine Infusion on Post Operative Pain and Morphine Consumption Following Major Gynaecological Surgeries Under General Anaesthesia. Journal of Gynecology and Obstetrics, 12(6), 140-149. https://doi.org/10.11648/j.jgo.20241206.13
ACS Style
Uchechukwu, A. N.; Ezeikel, O.; Ebere, A. E.; William, A. O.; Olung, A. J. The Effects of Intra-Operative Lidocaine Infusion on Post Operative Pain and Morphine Consumption Following Major Gynaecological Surgeries Under General Anaesthesia. J. Gynecol. Obstet. 2024, 12(6), 140-149. doi: 10.11648/j.jgo.20241206.13
AMA Style
Uchechukwu AN, Ezeikel O, Ebere AE, William AO, Olung AJ. The Effects of Intra-Operative Lidocaine Infusion on Post Operative Pain and Morphine Consumption Following Major Gynaecological Surgeries Under General Anaesthesia. J Gynecol Obstet. 2024;12(6):140-149. doi: 10.11648/j.jgo.20241206.13
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.jgo.20241206.13,
author = {Agwu Nnanna Uchechukwu and Oyewole Ezeikel and Agu Edith Ebere and Adeyemi Osebequin William and Achi Joseph Olung},
title = {The Effects of Intra-Operative Lidocaine Infusion on Post Operative Pain and Morphine Consumption Following Major Gynaecological Surgeries Under General Anaesthesia
},
journal = {Journal of Gynecology and Obstetrics},
volume = {12},
number = {6},
pages = {140-149},
doi = {10.11648/j.jgo.20241206.13},
url = {https://doi.org/10.11648/j.jgo.20241206.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20241206.13},
abstract = {Introduction: Major gynaecological surgeries are associated with considerable postoperative pain, which remains a challenge for many practitioners. Multimodal forms of analgesia significantly reduce the requirement of opioids for pain management. Despite its local anaesthetic effects, lidocaine infusion improves postoperative pain and morphine consumption following gynaecological surgeries. Materials and methods: Sixty patients were assigned randomly into 2 groups (A and B) with 30 patients per group. Group A received intravenous lidocaine 1.5 mg/kg at induction via a bolus injection and 1.5 mg/kg/hr in normal saline infusion from onset of surgery to the end of surgery, while the control group (Group B) received equal volume of normal saline at the same timelines. Pain scores were assessed postoperatively using the numerical rating scale and the cumulative morphine consumed postoperatively were also measured. Results: The mean pain scores were significantly higher in the Saline Group than in the Lidocaine group. The cumulative morphine consumption after 48 hours was significantly reduced in the study group 4.87 ± 1.80 mg vs 14.13 ± 4.10 mg (P<0.0001). Conclusion: The administration of a bolus dose (1.5 mg/kg) of intravenous lidocaine at induction and a continuous intravenous infusion of 1.5 mg/kg/hr from onset of surgery till skin closure reduced the postoperative pain intensity and morphine consumption in patients undergoing major gynaecological surgeries under general anaesthesia.
},
year = {2024}
}
TY - JOUR T1 - The Effects of Intra-Operative Lidocaine Infusion on Post Operative Pain and Morphine Consumption Following Major Gynaecological Surgeries Under General Anaesthesia AU - Agwu Nnanna Uchechukwu AU - Oyewole Ezeikel AU - Agu Edith Ebere AU - Adeyemi Osebequin William AU - Achi Joseph Olung Y1 - 2024/11/12 PY - 2024 N1 - https://doi.org/10.11648/j.jgo.20241206.13 DO - 10.11648/j.jgo.20241206.13 T2 - Journal of Gynecology and Obstetrics JF - Journal of Gynecology and Obstetrics JO - Journal of Gynecology and Obstetrics SP - 140 EP - 149 PB - Science Publishing Group SN - 2376-7820 UR - https://doi.org/10.11648/j.jgo.20241206.13 AB - Introduction: Major gynaecological surgeries are associated with considerable postoperative pain, which remains a challenge for many practitioners. Multimodal forms of analgesia significantly reduce the requirement of opioids for pain management. Despite its local anaesthetic effects, lidocaine infusion improves postoperative pain and morphine consumption following gynaecological surgeries. Materials and methods: Sixty patients were assigned randomly into 2 groups (A and B) with 30 patients per group. Group A received intravenous lidocaine 1.5 mg/kg at induction via a bolus injection and 1.5 mg/kg/hr in normal saline infusion from onset of surgery to the end of surgery, while the control group (Group B) received equal volume of normal saline at the same timelines. Pain scores were assessed postoperatively using the numerical rating scale and the cumulative morphine consumed postoperatively were also measured. Results: The mean pain scores were significantly higher in the Saline Group than in the Lidocaine group. The cumulative morphine consumption after 48 hours was significantly reduced in the study group 4.87 ± 1.80 mg vs 14.13 ± 4.10 mg (P<0.0001). Conclusion: The administration of a bolus dose (1.5 mg/kg) of intravenous lidocaine at induction and a continuous intravenous infusion of 1.5 mg/kg/hr from onset of surgery till skin closure reduced the postoperative pain intensity and morphine consumption in patients undergoing major gynaecological surgeries under general anaesthesia. VL - 12 IS - 6 ER -
Department of Anaesthesia and Intensive Care, University of Abuja Teaching Hospital (UATH), Abuja, Nigeria
Department of Anaesthesia and Intensive Care, University of Abuja Teaching Hospital (UATH), Abuja, Nigeria
Department of Anaesthesia and Intensive Care, University of Abuja Teaching Hospital (UATH), Abuja, Nigeria
Department of Anaesthesia and Intensive Care, University of Abuja Teaching Hospital (UATH), Abuja, Nigeria
Department of Anaesthesia and Intensive Care, University of Abuja Teaching Hospital (UATH), Abuja, Nigeria
