Skip to main content
Top
Published in: Obesity Surgery 10/2020

01-10-2020 | Opioids | Original Contributions

Assessment of the Effect of Perioperative Venous Lidocaine on the Intensity of Pain and IL-6 Concentration After Laparoscopic Gastroplasty

Authors: Caio Marcio Barros de Oliveira, Lais Maria Gaspar Coelho, José Aparecido Valadão, Ed Carlos Rey Moura, Antônio Augusto Moura da Silva, Roclides Castro de Lima, Milena Karina Coló Brunialti, Reinaldo Salomão, Plinio da Cunha Leal, Rioko Kimiko Sakata

Published in: Obesity Surgery | Issue 10/2020

Login to get access

Abstract

Background and Objectives

Opioids are associated with sedation and respiratory depression. The primary objective of this study was to assess pain intensity after gastric bypass with lidocaine. The secondary objective was to assess the IL-6 concentration, consumption of morphine, time to morphine request, time to extubation, and side effects.

Methods

Sixty patients aged 18 to 60 years, with ASA (American Society of Anesthesiologists) scores of 2 or 3, who underwent bariatric surgery were allocated to two groups. Patients in group 1 were administered lidocaine (1.5 mg/kg) 5 min before the induction of anesthesia, and group 2 was administered 0.9% saline solution in an equal volume. Subsequently, lidocaine (2 mg/kg/h) or 0.9% saline was infused during the entire surgical procedure. Anesthesia was performed with fentanyl (5 μg/kg), propofol, rocuronium, and sevoflurane. Postoperative patient-controlled analgesia was provided with morphine. The following were evaluated: pain intensity, IL-6, 24-h consumption of morphine, time to the morphine request, time to extubation, and adverse effects.

Results

The lidocaine group had a lower pain intensity than the saline group for up to 1 h, with no differences between groups in IL-6 and time to extubation. The lidocaine group consumed less morphine within 24 h, had a longer time until the first supplemental morphine request, and had a lower incidence of nausea.

Conclusions

Lidocaine reduced the intensity of early postoperative pain, incidence of nausea, and consumption of morphine within 24 h and increased time to the first morphine request, without reducing the plasma concentrations of IL-6.
Appendix
Available only for authorised users
Literature
1.
go back to reference Rawal N. Current issues in postoperative pain management. Eur J Anaesthesiol. 2016;33(3):160–71.PubMed Rawal N. Current issues in postoperative pain management. Eur J Anaesthesiol. 2016;33(3):160–71.PubMed
2.
go back to reference Weibel S, Jokinen J, Pace NL, et al. Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis. Br J Anaesth. 2016;116(6):770–83.PubMed Weibel S, Jokinen J, Pace NL, et al. Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis. Br J Anaesth. 2016;116(6):770–83.PubMed
3.
go back to reference Sabharwal A, Christelis N. Anesthesia for bariatric surgery. BJA Educ. 2010;10(4):99–103. Sabharwal A, Christelis N. Anesthesia for bariatric surgery. BJA Educ. 2010;10(4):99–103.
4.
go back to reference Nguyen NT, Wolfe BM. The physiologic effects of pneumoperitoneum in the morbidly obese. Ann Surg. 2005;241(2):219–26.PubMedPubMedCentral Nguyen NT, Wolfe BM. The physiologic effects of pneumoperitoneum in the morbidly obese. Ann Surg. 2005;241(2):219–26.PubMedPubMedCentral
5.
go back to reference de Oliveira CM, Sakata RK, Issy AM, et al. Cytokines and pain. Rev Bras Anestesiol. 2011;61(2):255–9. 60-5, 137-42PubMed de Oliveira CM, Sakata RK, Issy AM, et al. Cytokines and pain. Rev Bras Anestesiol. 2011;61(2):255–9. 60-5, 137-42PubMed
6.
go back to reference Lin E, Calvano SE, Lowry SF. Inflammatory cytokines and cell response in surgery. Surgery. 2000;127(2):117–26.PubMed Lin E, Calvano SE, Lowry SF. Inflammatory cytokines and cell response in surgery. Surgery. 2000;127(2):117–26.PubMed
7.
go back to reference Beilin B, Bessler H, Mayburd E, et al. Effects of preemptive analgesia on pain and cytokine production in the postoperative period. Anesthesiology. 2003;98(1):151–5.PubMed Beilin B, Bessler H, Mayburd E, et al. Effects of preemptive analgesia on pain and cytokine production in the postoperative period. Anesthesiology. 2003;98(1):151–5.PubMed
8.
go back to reference Azzam AAH, McDonald J, Lambert DG. Hot topics in opioid pharmacology: mixed and biased opioids. Br J Anaesth. 2019;122(6):e136–e45.PubMed Azzam AAH, McDonald J, Lambert DG. Hot topics in opioid pharmacology: mixed and biased opioids. Br J Anaesth. 2019;122(6):e136–e45.PubMed
9.
go back to reference De Jong A, Verzilli D, Geniez M, et al. Why is the morbidly obese patient at high risk of anesthetic complications? Presse Med. 2018;47(5):453–63.PubMed De Jong A, Verzilli D, Geniez M, et al. Why is the morbidly obese patient at high risk of anesthetic complications? Presse Med. 2018;47(5):453–63.PubMed
10.
go back to reference De Oliveira Jr GS, Duncan K, Fitzgerald P, et al. Systemic lidocaine to improve quality of recovery after laparoscopic bariatric surgery: a randomized double-blinded placebo-controlled trial. Obes Surg. 2014;24(2):212–8.PubMed De Oliveira Jr GS, Duncan K, Fitzgerald P, et al. Systemic lidocaine to improve quality of recovery after laparoscopic bariatric surgery: a randomized double-blinded placebo-controlled trial. Obes Surg. 2014;24(2):212–8.PubMed
11.
go back to reference de Oliveira CM, Issy AM, Sakata RK. Intraoperative intravenous lidocaine. Rev Bras Anestesiol. 2010;60(3):325–33.PubMed de Oliveira CM, Issy AM, Sakata RK. Intraoperative intravenous lidocaine. Rev Bras Anestesiol. 2010;60(3):325–33.PubMed
12.
go back to reference Cooke C, Kennedy ED, Foo I, et al. Meta-analysis of the effect of perioperative intravenous lidocaine on return of gastrointestinal function after colorectal surgery. Tech Coloproctol. 2019;23(1):15–24.PubMedPubMedCentral Cooke C, Kennedy ED, Foo I, et al. Meta-analysis of the effect of perioperative intravenous lidocaine on return of gastrointestinal function after colorectal surgery. Tech Coloproctol. 2019;23(1):15–24.PubMedPubMedCentral
13.
go back to reference Hollmann MW, Durieux ME. Local anesthetics and the inflammatory response: a new therapeutic indication? Anesthesiology. 2000;93(3):858–75.PubMed Hollmann MW, Durieux ME. Local anesthetics and the inflammatory response: a new therapeutic indication? Anesthesiology. 2000;93(3):858–75.PubMed
14.
go back to reference de Klaver MJ, Buckingham MG, Rich GF. Lidocaine attenuates cytokine-induced cell injury in endothelial and vascular smooth muscle cells. Anesth Analg. 2003;97(2):465–70. table of contentsPubMed de Klaver MJ, Buckingham MG, Rich GF. Lidocaine attenuates cytokine-induced cell injury in endothelial and vascular smooth muscle cells. Anesth Analg. 2003;97(2):465–70. table of contentsPubMed
15.
go back to reference De Oliveira Jr GS, Fitzgerald P, Streicher LF, et al. Systemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery. Anesth Analg. 2012;115(2):262–7.PubMed De Oliveira Jr GS, Fitzgerald P, Streicher LF, et al. Systemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery. Anesth Analg. 2012;115(2):262–7.PubMed
16.
go back to reference Li J, Wang G, Xu W, et al. Efficacy of intravenous lidocaine on pain relief in patients undergoing laparoscopic cholecystectomy: a meta-analysis from randomized controlled trials. Int J Surg. 2018;50:137–45.PubMed Li J, Wang G, Xu W, et al. Efficacy of intravenous lidocaine on pain relief in patients undergoing laparoscopic cholecystectomy: a meta-analysis from randomized controlled trials. Int J Surg. 2018;50:137–45.PubMed
17.
go back to reference Zhao JB, Li YL, Wang YM, et al. Intravenous lidocaine infusion for pain control after laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials. Medicine. 2018;97(5):e9771.PubMedPubMedCentral Zhao JB, Li YL, Wang YM, et al. Intravenous lidocaine infusion for pain control after laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials. Medicine. 2018;97(5):e9771.PubMedPubMedCentral
18.
go back to reference Weibel S, Jelting Y, Pace NL, et al. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults. Cochrane Database Syst Rev. 2018;6:Cd009642.PubMed Weibel S, Jelting Y, Pace NL, et al. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults. Cochrane Database Syst Rev. 2018;6:Cd009642.PubMed
19.
go back to reference Hermanns H, Hollmann MW, Stevens MF, et al. Molecular mechanisms of action of systemic lidocaine in acute and chronic pain: a narrative review. Br J Anaesth. 2019;123(3):335–49.PubMed Hermanns H, Hollmann MW, Stevens MF, et al. Molecular mechanisms of action of systemic lidocaine in acute and chronic pain: a narrative review. Br J Anaesth. 2019;123(3):335–49.PubMed
20.
go back to reference Soto G, Naranjo Gonzalez M, Calero F. Intravenous lidocaine infusion. Rev Esp Anestesiol Reanim. 2018;65(5):269–74.PubMed Soto G, Naranjo Gonzalez M, Calero F. Intravenous lidocaine infusion. Rev Esp Anestesiol Reanim. 2018;65(5):269–74.PubMed
22.
go back to reference Oliveira CM, Sakata RK, Slullitel A, et al. Effect of intraoperative intravenous lidocaine on pain and plasma interleukin-6 in patients undergoing hysterectomy. Rev Bras Anestesiol. 2015;65(2):92–8.PubMed Oliveira CM, Sakata RK, Slullitel A, et al. Effect of intraoperative intravenous lidocaine on pain and plasma interleukin-6 in patients undergoing hysterectomy. Rev Bras Anestesiol. 2015;65(2):92–8.PubMed
23.
go back to reference Han PY, Duffull SB, Kirkpatrick CM, et al. Dosing in obesity: a simple solution to a big problem. Clin Pharmacol Ther. 2007;82(5):505–8.PubMed Han PY, Duffull SB, Kirkpatrick CM, et al. Dosing in obesity: a simple solution to a big problem. Clin Pharmacol Ther. 2007;82(5):505–8.PubMed
24.
go back to reference Sakata RK, de Lima RC, Valadao JA, et al. Randomized, double-blind study of the effect of intraoperative intravenous lidocaine on the opioid consumption and criteria for hospital discharge after bariatric surgery. Obes Surg. 2020;30(4):1189-1193. https://doi.org/10.1007/s11695-019-04340-2. Sakata RK, de Lima RC, Valadao JA, et al. Randomized, double-blind study of the effect of intraoperative intravenous lidocaine on the opioid consumption and criteria for hospital discharge after bariatric surgery. Obes Surg. 2020;30(4):1189-1193. https://​doi.​org/​10.​1007/​s11695-019-04340-2.
25.
go back to reference Kim TH, Kang H, Hong JH, et al. Intraperitoneal and intravenous lidocaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study. Surg Endosc. 2011;25(10):3183–90.PubMed Kim TH, Kang H, Hong JH, et al. Intraperitoneal and intravenous lidocaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study. Surg Endosc. 2011;25(10):3183–90.PubMed
26.
go back to reference Kang H, Kim BG. Intravenous lidocaine for effective pain relief after inguinal herniorrhaphy: a prospective, randomized, double-blind, placebo-controlled study. J Int Med Res. 2011;39(2):435–45.PubMed Kang H, Kim BG. Intravenous lidocaine for effective pain relief after inguinal herniorrhaphy: a prospective, randomized, double-blind, placebo-controlled study. J Int Med Res. 2011;39(2):435–45.PubMed
27.
go back to reference Lang LH, Parekh K, Tsui BYK, et al. Perioperative management of the obese surgical patient. Br Med Bull. 2017;124(1):135–55.PubMedPubMedCentral Lang LH, Parekh K, Tsui BYK, et al. Perioperative management of the obese surgical patient. Br Med Bull. 2017;124(1):135–55.PubMedPubMedCentral
28.
go back to reference Pouwels S, Buise MP, Twardowski P, et al. Obesity surgery and anesthesiology risks: a review of key concepts and related physiology. Obes Surg. 2019;29(8):2670–7.PubMed Pouwels S, Buise MP, Twardowski P, et al. Obesity surgery and anesthesiology risks: a review of key concepts and related physiology. Obes Surg. 2019;29(8):2670–7.PubMed
29.
go back to reference Terkawi AS, Tsang S, Kazemi A, et al. A clinical comparison of intravenous and epidural local anesthetic for major abdominal surgery. Reg Anesth Pain Med. 2016;41(1):28–36.PubMedPubMedCentral Terkawi AS, Tsang S, Kazemi A, et al. A clinical comparison of intravenous and epidural local anesthetic for major abdominal surgery. Reg Anesth Pain Med. 2016;41(1):28–36.PubMedPubMedCentral
30.
go back to reference Beaussier M, Delbos A, Maurice-Szamburski A, et al. Perioperative use of intravenous lidocaine. Drugs. 2018;78(12):1229–46.PubMed Beaussier M, Delbos A, Maurice-Szamburski A, et al. Perioperative use of intravenous lidocaine. Drugs. 2018;78(12):1229–46.PubMed
31.
go back to reference Paterson HM. Continuous intravenous lidocaine infusion for postoperative pain and recovery in adults. Tech Coloproctol. 2019;23(1):69–71.PubMedPubMedCentral Paterson HM. Continuous intravenous lidocaine infusion for postoperative pain and recovery in adults. Tech Coloproctol. 2019;23(1):69–71.PubMedPubMedCentral
32.
go back to reference Bailey M, Corcoran T, Schug S, et al. Perioperative lidocaine infusions for the prevention of chronic postsurgical pain: a systematic review and meta-analysis of efficacy and safety. Pain. 2018;159(9):1696–704.PubMed Bailey M, Corcoran T, Schug S, et al. Perioperative lidocaine infusions for the prevention of chronic postsurgical pain: a systematic review and meta-analysis of efficacy and safety. Pain. 2018;159(9):1696–704.PubMed
33.
go back to reference Ventham NT, Kennedy ED, Brady RR, et al. Efficacy of intravenous lidocaine for postoperative analgesia following laparoscopic surgery: a meta-analysis. World J Surg. 2015;39(9):2220–34.PubMed Ventham NT, Kennedy ED, Brady RR, et al. Efficacy of intravenous lidocaine for postoperative analgesia following laparoscopic surgery: a meta-analysis. World J Surg. 2015;39(9):2220–34.PubMed
34.
go back to reference Kaba A, Laurent SR, Detroz BJ, et al. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. Anesthesiology. 2007;106(1):11–8. discussion 5-6PubMed Kaba A, Laurent SR, Detroz BJ, et al. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. Anesthesiology. 2007;106(1):11–8. discussion 5-6PubMed
35.
go back to reference Dunn LK, Durieux ME. Perioperative use of intravenous lidocaine. Anesthesiology. 2017;126(4):729–37.PubMed Dunn LK, Durieux ME. Perioperative use of intravenous lidocaine. Anesthesiology. 2017;126(4):729–37.PubMed
36.
go back to reference Araujo MC, Sinnott CJ, Strichartz GR. Multiple phases of relief from experimental mechanical allodynia by systemic lidocaine: responses to early and late infusions. Pain. 2003;103(1–2):21–9.PubMed Araujo MC, Sinnott CJ, Strichartz GR. Multiple phases of relief from experimental mechanical allodynia by systemic lidocaine: responses to early and late infusions. Pain. 2003;103(1–2):21–9.PubMed
37.
go back to reference Omote K. Intravenous lidocaine to treat postoperative pain management: novel strategy with a long-established drug. Anesthesiology. 2007;106(1):5–6. Omote K. Intravenous lidocaine to treat postoperative pain management: novel strategy with a long-established drug. Anesthesiology. 2007;106(1):5–6.
38.
go back to reference Hahnenkamp K, Durieux ME, Hahnenkamp A, et al. Local anaesthetics inhibit signalling of human NMDA receptors recombinantly expressed in Xenopus laevis oocytes: role of protein kinase C. Br J Anaesth. 2006;96(1):77–87.PubMed Hahnenkamp K, Durieux ME, Hahnenkamp A, et al. Local anaesthetics inhibit signalling of human NMDA receptors recombinantly expressed in Xenopus laevis oocytes: role of protein kinase C. Br J Anaesth. 2006;96(1):77–87.PubMed
39.
go back to reference Yanagidate F, Strichartz GR. Local anesthetics. Handb Exp Pharmacol. 2007;177:95–127. Yanagidate F, Strichartz GR. Local anesthetics. Handb Exp Pharmacol. 2007;177:95–127.
40.
go back to reference Petrenko AB, Yamakura T, Baba H, et al. The role of N-methyl-D-aspartate (NMDA) receptors in pain: a review. Anesth Analg. 2003;97(4):1108–16.PubMed Petrenko AB, Yamakura T, Baba H, et al. The role of N-methyl-D-aspartate (NMDA) receptors in pain: a review. Anesth Analg. 2003;97(4):1108–16.PubMed
41.
go back to reference Watkins LR, Maier SF. Beyond neurons: evidence that immune and glial cells contribute to pathological pain states. Physiol Rev. 2002;82(4):981–1011.PubMed Watkins LR, Maier SF. Beyond neurons: evidence that immune and glial cells contribute to pathological pain states. Physiol Rev. 2002;82(4):981–1011.PubMed
42.
go back to reference Ortiz MP, Godoy MC, Schlosser RS, et al. Effect of endovenous lidocaine on analgesia and serum cytokines: double-blinded and randomized trial. J Clin Anesth. 2016;35:70–7.PubMed Ortiz MP, Godoy MC, Schlosser RS, et al. Effect of endovenous lidocaine on analgesia and serum cytokines: double-blinded and randomized trial. J Clin Anesth. 2016;35:70–7.PubMed
Metadata
Title
Assessment of the Effect of Perioperative Venous Lidocaine on the Intensity of Pain and IL-6 Concentration After Laparoscopic Gastroplasty
Authors
Caio Marcio Barros de Oliveira
Lais Maria Gaspar Coelho
José Aparecido Valadão
Ed Carlos Rey Moura
Antônio Augusto Moura da Silva
Roclides Castro de Lima
Milena Karina Coló Brunialti
Reinaldo Salomão
Plinio da Cunha Leal
Rioko Kimiko Sakata
Publication date
01-10-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 10/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04748-1

Other articles of this Issue 10/2020

Obesity Surgery 10/2020 Go to the issue