Efficacy of intraperitoneal and intravenous lidocaine on pain relief after laparoscopic cholecystectomy

Objectives This randomized, double-blind, placebo-controlled trial evaluated intraperitoneal (IP) lidocaine administration and intravenous (IV) lidocaine infusion for postoperative pain control after laparoscopic cholecystectomy (LC). Methods Patients who underwent LC were randomized to either group IV (intravenous lidocaine infusion), group IP (intraperitoneal lidocaine administration), or group C (control, IP and IV saline). Outcome measures were total postoperative pain severity (TPPS), total fentanyl consumption (TFC), frequency of administering patient-controlled analgesia (FPB), and a pain control satisfaction score (PCSS). Results Significantly reduced TPPS, TFC and FPB scores were observed in groups IP (n=22) and IV (n=26) compared with controls (n=24). PCSS was higher in groups IP and IV than in controls. At 2h postoperation, TPPS was significantly lower in group IP than group IV; at 0-2h postoperation, FPB was lower in group IP than group IV. Conclusions The IP administration of lidocaine and IV lidocaine infusion significantly reduced postoperative pain and opioid consumption in LC patients, compared with control infusions. For convenience, IV lidocaine could be used for pain reduction following LC; IP administration places additional burden on the surgeon.