Postoperative analgesic efficacy of perioperative intravenous lidocaine infusion in patients undergoing septorhinoplasty: a prospective, randomized, double-blind study

Purpose Intravenous lidocaine infusion has been used for postoperative analgesia in many surgical procedures in recent years. The aim of this randomized, double-blind study was to investigate the postoperative analgesic efficacy of perioperative intravenous lidocaine infusion in patients undergoing septorhinoplasty surgery. Materials and methods Forty-eight American Society of Anesthesiologists I and II patients, aged 18-40 years scheduled for septorhinoplasty surgery, were assigned into two groups. Before anesthesia induction, patients in the lidocaine group (Group L, n = 24) received an intravenous bolus infusion of 1.5 mg/kg lidocaine followed by a continuous infusion of 1.5 mg/kg/h during the operation and until the end of the first postoperative hour. Patients in the control group (Group C, n = 24) received normal saline according to the same protocol. In the postoperative period, 50 mg dexketoprofen trometamol was administered and repeated every 12 h. Postoperative pain scores, rescue analgesia, intraoperative opioid requirements, and side effects were recorded. Results Postoperative pain scores were significantly lower in Group L than in Group C at postoperative 30 min, 1, 2, 4, 8, 12 and 24 h (p < 0.05). There was no difference between groups intraoperative remifentanil consumption (p > 0.05). Rescue analgesia use was statistically significantly higher in Group C than in Group L (12/24 versus 1/24, respectively, p = 0.001). Postoperative nausea was statistically higher in Group C than in Group L (13/24 versus 5/24 respectively, p = 0.017), whereas other side-effects were similar for the two groups (p > 0.05). Discussion We recommended the use of intravenous lidocaine infusion for intraoperatively and first postoperative hours in septorhinoplasty surgery as it reduces pain scores and the need for additional opioid use.