Intraoperative intravenous lidocaine reduces hospital length of stay following open gastrectomy for stomach cancer in men.

STUDY OBJECTIVE: To evaluate whether intraoperative low-dose lidocaine infusion decreases postoperative analgesic consumption, ileus, and duration of hospital stay.

DESIGN: Prospective, randomized, double-blinded trial.

SETTING: Operating room in a university hospital.

PATIENTS: 48 ASA physical status 1 and 2 men scheduled for subtotal gastrectomy.

INTERVENTIONS: Patients were randomly allocated to two groups to receive either intravenous (IV) lidocaine 1.5 mg/kg 20 minutes before incision followed by a continuous lidocaine infusion of 1.5 mg/kg/hr until the end of surgery (lidocaine group) or saline in a similar manner (control group).

MEASUREMENTS: Outcomes such as pain intensity, postoperative analgesic consumption, duration of ileus, and hospital length of stay (LOS) were recorded.

MAIN RESULTS: There were no differences in total consumption of IV patient-controlled analgesia (IVPCA) or pain scores at 24, 48, or 72 hours postoperatively. However, lidocaine group patients had significantly decreased average supplemental pethidine requirement per patient for pain control until 72 hours postoperatively [150 (75-200) mg vs 50 (50-150) mg, P = 0.039] and hospital LOS (9.5 ± 3 d vs 8.7 ± 1 d, P = 0.006, 95% CI: - 0.3 - 1.9 d) than control group patients. However, no differences were noted between the groups in pain intensity or duration of ileus.

CONCLUSIONS: Intraoperative IV low-dose lidocaine infusion decreased opioid consumption and hospital LOS after gastrectomy.