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Clinical Research
Anesthetic Pharmacology
Anesthesia and Pain Medicine 2014;9(3):185-192.
Published online July 31, 2014.
Effect of perioperative infusion of lidocaine vs. dexmedetomidine on reduced consumption of postoperative analgesics after laparoscopic cholecystectomy
Kwangrae Cho, Jeong Han Lee, Myoung Hun Kim, Wonjin Lee, Se Hun Lim, Kun Moo Lee, Seunghee Ki, Jong Han Kim
Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. maeteo@hanmir.com
Received: 10 December 2013   • Revised: 11 February 2014
Abstract
BACKGROUND
Postoperative pain is the most common complaint of patients following laparoscopic cholecystectomy (LC). Intravenous lidocaine has analgesic, anti-hyperalgesic, and anti-inflammatory effects, and dexmedetomidine has anti-nociceptive and analgesic sparing effects. We evaluated the effects of perioperative intravenous infusion of lidocaine and dexmedetomidine on postoperative pain control and analgesic consumption after LC.
METHODS
Eighty-four patients, aged 20-60 years, who were undergoing elective LC were assigned randomly to three groups (n = 28 in each). The patients in group L received an intravenous lidocaine bolus of 1.5 mg/kg and then continuous infusion of 2 mg/kg/hr. The group D received an intravenous dexmedetomidine bolus of 1 microg/kg, followed by continuous infusion of 0.4 microg/kg/hr. The group N received saline as described for group L. Bolus doses were given during the 10 minutes before the induction of anesthesia, followed by continuous infusion until end of the surgery. Visual analogue scale (VAS) score and postoperative analgesics consumption were evaluated during 24 hours after the surgery.
RESULTS
No significant difference was observed in VAS score among the groups during the first 24 hr after LC. The amount of fentanyl consumption in the post-anesthesia care unit was significantly less in groups L and D compared to group N.
CONCLUSIONS
Both perioperative intravenous infusion of dexmedetomidine and lidocaine reduced postoperative requirements of fentanyl in the early post-operative period after LC. However, there was no significant difference between dexmedetomidine and lidocaine in the analgesic sparing effect.
Key Words: Dexmedetomidine, Laparoscopic cholecystectomy, Lidocaine, Postoperative pain
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