title: Systemic lidocaine to improve quality of recovery after laparoscopic bariatric surgery: a randomized double-blinded placebo-controlled trial.
abstract: BACKGROUND
  Few multimodal strategies to minimize postoperative pain and improve recovery have been examined in morbidly obese patients undergoing laparoscopic bariatric surgery. The main objective of this study was to evaluate the effect of systemic intraoperative lidocaine on postoperative quality of recovery when compared to saline.
  
  
  METHODS
  The study was a prospective randomized, double-blinded placebo-controlled clinical trial. Subjects undergoing laparoscopic bariatric surgery were randomized to receive lidocaine (1.5 mg/kg bolus followed by a 2 mg/kg/h infusion until the end of the surgical procedure) or the same volume of saline. The primary outcome was the quality of recovery 40 questionnaire at 24 h after surgery.
  
  
  RESULTS
  Fifty-one subjects were recruited and 50 completed the study. The global QoR-40 scores at 24 h were greater in the lidocaine group median (IQR) of 165 (151 to 170) compared to the saline group, median (IQR) of 146 (130 to 169), P = 0.01. Total 24 h opioid consumption was lower in the lidocaine group, median (IQR) of 26 (19 to 46) mg IV morphine equivalents compared to the saline group, median (IQR) of 36 (24 to 65) mg IV morphine equivalents, P = 0.03. Linear regression demonstrated an inverse relationship between the total 24 h opioid consumption (IV morphine equivalents) and 24 h postoperative quality of recovery (P < 0.0001).
  
  
  CONCLUSIONS
  Systemic lidocaine improves postoperative quality of recovery in patients undergoing laparoscopic bariatric surgery. Patients who received lidocaine had a lower opioid consumption which translated to a better quality of recovery.
authors.affiliation: Department of Anesthesiology, Northwestern University, Chicago, IL, USA, g-jr@northwestern.edu.
authors.forename: Gildasio S
authors.initials: GS
authors.lastname: De Oliveira
authors.forename: Kenyon
authors.initials: K
authors.lastname: Duncan
authors.forename: Paul
authors.initials: P
authors.lastname: Fitzgerald
authors.forename: Antoun
authors.initials: A
authors.lastname: Nader
authors.forename: Robert W
authors.initials: RW
authors.lastname: Gould
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage*; D050110:Bariatric Surgery; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008012:Lidocaine
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