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Title: | Systemic lidocaine fails to improve postoperative morphine consumption, postoperative recovery and quality of life in patients undergoing posterior spinal arthrodesis. A double-blind, randomized, placebo-controlled trial | Authors: | Dewinter, Geertrui Barbara Erika Moens, Pierre FIEUWS, Steffen Vanaudenaerde, Bart Van de Velde, Marc Rex, Stephen |
Issue Date: | 2017 | Publisher: | ELSEVIER SCI LTD | Source: | BRITISH JOURNAL OF ANAESTHESIA, 118(4), p. 576-585 | Abstract: | Background. It is inconclusive whether the perioperative administration of systemic lidocaine provides effective postoperative analgesia and enhances recovery in major orthopaedic surgery. We hypothesised that in adolescent and adult patients undergoing posterior spinal arthrodesis, a perioperative lidocaine infusion would reduce opioid requirements during the first 24 postoperative h. Methods. 70 patients undergoing posterior arthrodesis were enrolled in this prospective, randomised, double-blind, placebo-controlled clinical trial. Patients received total i.v. anaesthesia with propofol and remifentanil and were randomized to an adjuvant therapy with either lidocaine [i.v.-bolus injection of 1.5 mg kg(-1) at induction of anaesthesia, followed by an infusion of 1.5 mg kg(-1) h(-1) which was continued until six h after arrival at the post-anaesthesia care unit] or placebo (equal volumes of saline). Postoperative pain was treated with patient-controlled i.v. morphine. Primary endpoints of this study were morphine requirements in the first postoperative 24 h. Results. Systemic lidocaine did not decrease morphine requirements in the first 24 postoperative h [lidocaine-group: 48 (23) mg (mean(SD)) vs placebo-group: 51(19) mg, P = 0.22]. Likewise, groups were not different with respect to the severity of postoperative pain, morphine consumption after 48 and 72 h, incidence of postoperative nausea and vomiting, perioperative inflammation, time to recovery of intestinal function, hospital length of stay, and quality of life (assessed preoperatively and one month postoperatively using the SF-12 physical and mental composite scores). Conclusions. In our study, systemic lidocaine had no analgesic benefits in posterior arthrodesis when added to an opioidbased anaesthetic regimen. | Notes: | [Dewinter, G.; Van de Velde, M.; Rex, S.] Katholieke Univ Leuven, Univ Hosp, Dept Anaesthesiol, Herestr 49, B-3000 Leuven, Belgium. [Moens, P.] Katholieke Univ Leuven, Univ Hosp, Dept Orthopaed Surg, Herestr 49, B-3000 Leuven, Belgium. [Fieuws, S.] KU Leuven Univ Leuven, B-3000 Leuven, Belgium. [Fieuws, S.] Univ Hasselt, Interuniv Inst Biostat & Stat Bioinformat, B-3000 Leuven, Belgium. [Vanaudenaerde, B.] KU Leuven Univ Leuven, Dept Clin & Expt Med, Herestr 49, B-3000 Leuven, Belgium. [Van de Velde, M.; Rex, S.] KU Leuven Univ Leuven, Dept Cardiovasc Sci, Herestr 49, B-3000 Leuven, Belgium. | Keywords: | lidocaine; pain; postoperative; spinal fusion;lidocaine; pain; postoperative; spinal fusion | Document URI: | http://hdl.handle.net/1942/26376 | ISSN: | 0007-0912 | e-ISSN: | 1471-6771 | DOI: | 10.1093/bja/aex038 | ISI #: | 000400986300015 | Rights: | (C) The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2018 |
Appears in Collections: | Research publications |
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Fieuws.pdf | Published version | 390.47 kB | Adobe PDF | View/Open |
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