Abstract
Background
Intravenous (IV) lidocaine is a proven analgesic therapy but has not been evaluated
in extensive procedures such as cytoreductive surgery (CRS). Our aim was to assess
the effectiveness and safety of IV lidocaine in this setting.
Methods
This is a retrospective hybrid case-cohort study investigating analgesic effectiveness
and complications of perioperative IV lidocaine at 1.5 mg/kg/h for 48 h compared to
thoracic epidural anaesthesia (TEA) among patients undergoing CRS in a high-volume
centre.
Results
Sixty patients were included, 20 received IV lidocaine and 40 underwent TEA. Pain
scores were low (median ≤2) and similar in both groups (p = 0.88). At 72 h, the lidocaine
group had a lower median pain score (p = 0.03). Overall opioid consumption in the
first 48 h was lower in the lidocaine compared to the TEA group (median 0 (IQR 0–9.5)
mg vs. 45.4 (0–62.4) MME respectively, p = 0.001). Opioid consumption was also lower
in the lidocaine compared to the TEA group during the whole 5-day period (median 1
(IQR 1–13.5) mg vs. 112 (36.6–137.85) MME respectively, p = 0.000). The incidence
of PONV was significantly lower in the lidocaine group (27.5% vs 5%, p = 0.047) with
no difference in other complications or length of in-hospital stay.
Conclusion
Intravenous lidocaine infusion may be a safe and effective analgesic approach in CRS
and is associated with a significant reduction of opioid use and PONV compared to
opioid-containing TEA.
Keywords
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Article info
Publication history
Published online: November 17, 2022
Accepted:
November 17,
2022
Received in revised form:
October 12,
2022
Received:
June 19,
2022
Identification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
