Can intravenous lidocaine decrease postsurgical ileus and shorten hospital stay in elective bowel surgery? A pilot study and literature review.
BACKGROUND
This study examined whether systemic infusion of lidocaine, a local anesthetic with anti-inflammatory properties, can decrease surgical pain, length of postsurgical ileus, and hospital stay.


METHODS
Twenty-two patients at a community hospital were randomized into 2 groups. Subjects were allocated to receive either lidocaine or a placebo infusion for the first 24 hours after surgery.


RESULTS
Patients in the lidocaine group appeared to report less pain as reflected by a decrease in overall visual analogue scale pain scores 24 hours after surgery. The return of flatus after surgery was not considered significant (lidocaine 68.2 +/- 9.7 hours vs placebo 86.9 +/- 13.6 hours; P = .2802). The return of bowel movement after surgery was considered significant (lidocaine 88.3 +/- 6.08 hours vs placebo group 116 +/- 10.1 hours; P = .0286). The lidocaine group was discharged by mean day 3.76 +/- .24 versus placebo at mean day 4.93 +/- .42; P = .0277.


CONCLUSIONS
Patients in the lidocaine group had bowel movements >24 hours earlier than those in the placebo group and were discharged earlier.
Harvey
Kyle P
KP
Department of Surgery, St. Joseph Mercy Oakland Hospital, Pontiac, MI, USA. kharvey06@hotmail.com
Adair
James D
JD
Isho
Mayyas
M
Robinson
Robert
R
D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use*; D003672:Defecation; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D045823:Ileus / Q000188:drug therapy*; D007262:Infusions, Intravenous; D007422:Intestines / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D010865:Pilot Projects; D011183:Postoperative Complications / Q000188:drug therapy*
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D008012:Lidocaine