Intravenous lidocaine after hepatectomy
Trial question
What is the effect of prolonged intravenous lidocaine infusion following hepatectomy?
Study design
Single center
Double blinded
RCT
Population
260 patients.
Inclusion criteria: patients undergoing elective hepatectomy.
Key exclusion criteria: body weight < 40 kg or > 100 kg; metastases occurring in other distant organs; severe hepatic insufficiency; renal impairment; cardiac rhythm disorder or systolic HF.
Interventions
N=130 lidocaine (infusion of intravenous lidocaine hydrochloride 1.5 mg/kg during anesthesia).
N=130 placebo (infusion of 0.9% normal saline during anesthesia).
Primary outcome
Moderate-to-severe movement-evoked pain at 24 hour postoperatively
47.7%
67.7%
67.7 %
50.8 %
33.9 %
16.9 %
0.0 %
Lidocaine
Placebo
Significant
decrease ▼
NNT = 5
Significant decrease in moderate-to-severe movement-evoked pain at 24 hour postoperatively (47.7% vs. 67.7%; RR 0.71, 95% CI 0.29 to 1.13).
Secondary outcomes
Significant decrease in moderate-to-severe movement-evoked pain at 48 hour postoperatively (38.5% vs. 58.5%; RR 0.66, 95% CI 0.27 to 1.05).
Significantly lower reduction in movement-evoked pain scores (3.7 points vs. 4.2 points; AD -0.5 points, 95% CI -0.9 to -0.1).
Significant decrease in morphine equivalent connsumption (47.2 mg vs. 52.6 mg; AD -5.4 mg, 95% CI -9.8 to -1).
Conclusion
In patients undergoing elective hepatectomy, lidocaine was superior to placebo with respect to a moderate-to-severe movement-evoked pain at 24 hour postoperatively.
Reference
Yan Xu, Mao Ye, Fei Liu et al. Efficacy of prolonged intravenous lidocaine infusion for postoperative movement-evoked pain following hepatectomy: a double-blinded, randomised, placebo-controlled trial. Br J Anaesth. 2023 Jul;131(1):113-121.
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