title: Acute rehabilitation program after laparoscopic colectomy using intravenous lidocaine.
abstract: BACKGROUND
  The concept of postoperative acute rehabilitation was introduced to accelerate postoperative recovery and improve outcome. We investigated whether intravenous lidocaine infusion, which decreases postoperative pain and speeds the return of bowel function, can be used instead of epidural analgesia in an acute rehabilitation protocol for patients undergoing laparoscopic colectomy.
  
  
  METHODS
  Twenty eight consecutive patients scheduled for laparoscopic colectomy were prospectively included in this case series study. Segmental colectomy was performed only for benign pathology. Intraoperative opioid use was restricted. After a bolus injection of lidocaine 1.5 mg x kg(-1), an infusion (2 mg x kg(-1) x h(-1), i.v.) was started before pneumoperitoneum. Balanced analgesia was used to reduce postoperative opioid consumption. Patients were allowed to drink 6 h postoperatively. The day after surgery, patients were allowed to eat a normal breakfast. Enforced mobilisation and ambulation were required from the patients. Our goal was to discharge patients within 3 days after surgery. Postoperative pain was measured. Time to first flatus, defecation, and hospital discharge were recorded.
  
  
  RESULTS
  Mean postoperative pain at rest and mobilisation remained below 30 mm on a 100 mm visual analogue scale. Time to first flatus, defecation, and hospital discharge were 29 +/- 13 h, 38 +/- 13 h, and 3.0 +/- 1.0 days, respectively.
  
  
  CONCLUSIONS
  Acute rehabilitation after laparoscopic colectomy using i.v. lidocaine gives similar outcomes to those reported using epidural analgesia.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, CHU de Liege, Domaine du Sart-Tilman, Liège, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Kaba
authors.forename: B J
authors.initials: BJ
authors.lastname: Detroz
authors.forename: S R
authors.initials: SR
authors.lastname: Laurent
authors.forename: M L
authors.initials: ML
authors.lastname: Lamy
authors.forename: J L
authors.initials: JL
authors.lastname: Joris
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D003082:Colectomy / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D010535:Laparoscopy / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine