title: Benefits of intravenous lidocaine on post-operative pain and acute rehabilitation after laparoscopic nephrectomy.
abstract: OBJECTIVE
  Intravenous (I.V.) lidocaine has analgesic, antihyperalgesic and anti-inflammatory properties and is known to accelerate the return of bowel function after surgery. We evaluated the effects of I.V. lidocaine on pain management and acute rehabilitation protocol after laparoscopic nephrectomy.
  
  
  METHODS
  A total of 47 patients scheduled to undergo laparoscopic nephrectomy were included in a two-phase observational study where I.V. lidocaine (1.5 mg/kg/h) was introduced, in the second phase, during surgery and for 24 h post-operatively. All patients underwent the same post-operative rehabilitation program. Post-operative pain scores, opioid consumption and extent of hyperalgesia were measured. Time to first flatus and 6 min walking test (6MWT) were recorded.
  
  
  RESULTS
  Patient demographics were similar in the two phases (n = 22 in each group). Lidocaine significantly reduced morphine consumption (median [25-75% interquartile range]; 8.5 mg[4567891011121314151617] vs. 25 mg[1920212223242526272829303132]; P < 0.0001), post-operative pain scores (P < 0.05) and hyperalgesia extent on post-operative day 1-day 2-day 4 (mean ± standard deviation (SD); 1.5 ± 0.9 vs. 4.3 ± 1.2 cm (P < 0.001), 0.6 ± 0.5 vs. 2.8 ± 1.2 cm (P < 0.001) and 0.13 ± 0.3 vs. 1.2 ± 1 cm (P < 0.001), respectively). Time to first flatus (mean ± SD; 29 ± 7 h vs. 48 ± 15 h; P < 0.001) and 6MWT at day 4 (189 ± 50 m vs. 151 ± 53 m; P < 0.001) were significantly enhanced in patients with i.v. lidocaine.
  
  
  CONCLUSIONS
  Intravenous (I.V.) lidocaine could reduce post-operative morphine consumption and improve post-operative pain management and post-operative recovery after laparoscopic nephrectomy. I.V. lidocaine could contribute to better post-operative rehabilitation.
authors.affiliation: Department of Anesthesiology, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux cedex, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Tauzin-Fin
authors.affiliation: Department of Anesthesiology, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux cedex, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bernard
authors.affiliation: Department of Anesthesiology, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux cedex, France.
authors.forename: Musa
authors.initials: M
authors.lastname: Sesay
authors.affiliation: Department of Anesthesiology, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux cedex, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Biais
authors.affiliation: Department of Anesthesiology, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Richebe
authors.affiliation: Department of Anesthesiology, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux cedex, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Quinart
authors.affiliation: Department of Anesthesiology, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Revel
authors.affiliation: Department of Anesthesiology, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux cedex, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Sztark
keywords: Analgesia; laparoscopic nephrectomy; lidocaine; post-operative pain