Intraoperative systemic infusion of lidocaine reduces postoperative pain after lumbar surgery: a double-blinded, randomized, placebo-controlled clinical trial.
BACKGROUND
Analgesic effect of lidocaine infusion on postoperative pain.


OBJECTIVE
The aim of this study was to evaluate the analgesic effect of lidocaine infusion on postoperative pain after lumbar microdiscectomy.


METHODS
This study used a prospective, randomized, double-blinded, and placebo-controlled clinical trial.


METHODS
Fifty-one patients participated in this randomized, double-blinded study.


METHODS
The primary outcome was the visual analog scale (VAS) (0-100 mm) pain score at 4 hours after surgery. The secondary outcomes were the VAS pain score at 2, 8, 12, 24, and 48 hours after surgery, the frequency with which patients pushed the button (FPB) of the patient-controlled analgesia system, and the fentanyl consumption at 2, 4, 8, 12, 24, and 48 hours after surgery. Other outcomes were satisfaction scores regarding pain control and the overall recovery process, incidence of postoperative nausea and vomiting (PONV), and length of hospital stay (HS).


METHODS
Preoperatively and throughout the surgery, Group L received intravenous lidocaine infusion (a 1.5-mg/kg bolus followed by a 2-mg/kg/h infusion until the end of the surgical procedure) and Group C received normal saline infusion as a placebo.


RESULTS
The VAS scores and fentanyl consumption were significantly lower in Group L compared with Group C except at 48 h after surgery (p<.05). Total fentanyl consumption, total FPB, length of HS, and satisfaction scores were also significantly lower in Group L compared with Group C (p<.05).


CONCLUSIONS
Intraoperative systemic infusion of lidocaine decreases pain perception during microdiscectomy, thus reducing the consumption of opioid and the severity of postoperative pain. This effect contributes to reduce the length of HS.
Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 700-720, Korea.
Kyoung-Tae
KT
Kim
Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 700-720, Korea.
Dae-Chul
DC
Cho
Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 700-720, Korea.
Joo-Kyung
JK
Sung
Department of Neurosurgery, College of Medicine, Chung-Ang University Hospital, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, Korea.
Young-Baeg
YB
Kim
Department of Anaesthesiology and Pain Medicine, College of Medicine, Chung-Ang University Hospital, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, Korea. Electronic address: roman00@cau.ac.kr.
Hyun
H
Kang
Department of Orthopedic Surgery, College of Medicine, Chung-Ang University Hospital, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, Korea.
Kwang-Sup
KS
Song
Department of Anaesthesiology and Pain Medicine, College of Medicine, Chung-Ang University Hospital, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, Korea.
Geun-Joo
GJ
Choi
D000328:Adult; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D017586:Diskectomy / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D007796:Laminectomy / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008012:Lidocaine; D005283:Fentanyl
Inflammation; Lidocaine; Microdiscectomy; Muscle injury; Opioid consumption; Postoperative pain