Abstract:
Introduction: An increasing amount of evidence suggest that intraoperative intravenous lidocaine
infusion can influence pain severity, postoperative analgesic requirement and decrease opioid side
effects in a patient with abdominal surgery. Postoperative pain might be due to the damage of
muscles and tissues. The importance of pain relief is well-recognized, but it is most often seen that
pain control is inadequate. Results of previous study shows the opioid consumption is 70% after
abdominal surgery, so that multimodal approach for managing pain will decrease opioid
consumption.
Objective: To assess analgesic effectiveness of intraoperative intravenous lidocaine infusion as
part of postoperative analgesia for patients undergoing abdominal surgery under general
anesthesia in Jimma university medical center.
Methods: Institutional based prospective cohort study conducted in 38 patients with American
Society of Anesthesiologist (ASA) class I and II, age ≥ 18 and elective abdominal patients in
which they undergone abdominal surgery and grouped into exposed and non-exposed group based
on lidocaine infusion (1mg/kg/hr.) or not. Consecutive sampling was employed to recruit study
subjects. Data was entered to Epidata v 4.6 and exported to SPSS V26 for analysis. The ShapiroWilk test with a p value <0.05 for non-normally distributed data and a histogram with bellshaped were used to test for normal distributions of data. The comparison of numerical
variables between study groups was done using the unpaired student t-test and Mann-Whitney
U test based on normally distributed data and non-normally distributed data, respectively. Box
and whisker plot were used to show a median pain score differences between groups.
Result: Demographic characteristics were comparable between the groups, p>0.05. Twenty-fourhour median VAS score (0 to 10 cm) at 3rd, and 6th hour showing lower median pain score, with
p<0.05. The median time to first analgesia request in minutes were longer (242.11 minutes) in
exposed group compared to 91.5 minutes in non-exposed group (p= <0.001). The median
tramadol consumption within 24 hour is 100mg in exposed group compared to 150 mg in nonexposed group(p<0.001).
Conclusion and recommendation: Intraoperative lidocaine infusion decreases postoperative pain
score, total analgesia consumption and prolongs time to first analgesia request for abdominal
surgery done under general anesthesia. Based on these we recommend use of 1 mg/kg/hr of 2%
lidocaine infusion is an effect postoperative analgesia.
