title: Effects of intravenous versus epidural lidocaine infusion on pain intensity and bowel function after major large bowel surgery: a double-blind randomized controlled trial.
abstract: BACKGROUND
  We compared the effects of intravenous lidocaine (IVL) with lumbar epidural lidocaine analgesia (LEA) on pain and ileus after open colonic surgery.
  
  
  METHODS
  Between December 2011 and February 2013, 60 patients were randomly allocated to IVL, LEA, or control group. The IVL group received intraoperatively lidocaine 2 % intravenously (1.5 mg/kg bolus, 2 mg/kg/h infusion) and normal saline (NS) epidurally. The LEA group received lidocaine epidurally (1.5 mg/kg bolus, 2 mg/kg/h infusion) and NS intravenously. The control group received NS both intravenously and epidurally, as bolus and infusion. All NS volumes were calculated as if containing lidocaine 2 % at the aforementioned doses. We assessed pain intensity at rest/cough at 1, 2, 4, 12, 24, and 48 h postoperatively (numerical rating scale 0-10), 48-h analgesic consumption, and time to first flatus passage.
  
  
  RESULTS
  Data from 60 patients (20 per group) were analyzed. The IVL group had significantly lower pain scores at rest and cough compared to LEA or control group only at 1, 2, and 4 h postoperatively (P < 0.005 for all comparisons). The 48-h analgesic requirements and time to first flatus passage did not differ significantly between IVL group and LEA or control group (P > 0.05).
  
  
  CONCLUSIONS
  Compared with LEA-lidocaine or placebo, intravenous lidocaine offered no clinically significant benefit in terms of analgesia and bowel function.
authors.affiliation: First Department of Anesthesiology, Aretaieion Hospital, University of Athens School of Medicine, 76 Vass. Sophias Av., 11528, Athens, Greece, c_staikou@yahoo.gr.
authors.forename: Chryssoula
authors.initials: C
authors.lastname: Staikou
authors.forename: Alexandra
authors.initials: A
authors.lastname: Avramidou
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Ayiomamitis
authors.forename: Spyros
authors.initials: S
authors.lastname: Vrakas
authors.forename: Eriphili
authors.initials: E
authors.lastname: Argyra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D003108:Colonic Diseases / Q000503:physiopathology / Q000601:surgery*; D003672:Defecation / Q000502:physiology*; D013505:Digestive System Surgical Procedures; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007268:Injections, Epidural; D007420:Intestine, Large / Q000503:physiopathology* / Q000601:surgery*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine