Intravenous or intraperitoneal lidocaine infusions (IVL, IPL) were promising developing analgesic alternatives after laparoscopic colectomy. Even though both methods were promising, no direct, prospective randomized comparisons in patients undergoing laparoscopic colon resection have been conducted. For a study, researchers sought to compare IPL and IVL. Patients undergoing laparoscopic colonic excision were studied in a double-blind, randomized controlled trial. The 2 groups were given equivalent dosages of IPL or IVL, which began intra-operatively with a bolus and continued for 3 days postoperatively. Investigators used a standardized accelerated recovery after surgery program to look after the patients. The primary outcome was total opioid intake in the first 3 days after surgery. Patients were monitored for 60 days. About 56 patients were randomly assigned to the IVL or IPL groups in a 1:1 ratio. Total opioid intake during the first 3 days after surgery was significantly lower in the IPL group (70.9 mg vs 157.8 mg P<0.05), as was overall opioid consumption during the entire stay (80.3 mg vs 187.36 mg P<0.05). The IPL group had significantly lower pain scores at 2 hours postoperatively, but no other time points were significant. There were no significant variations in the number of problems between the 2 groups. Compared to IVL, perioperative use of IPL results in a considerable reduction in opioid usage following laparoscopic colon surgery. The peritoneal cavity/compartment was an excellent place to administer a local anesthetic. IPL should be considered part of multimodal pain management following colectomy in future enhanced recovery after surgery recommendations.

 

Source:journals.lww.com/annalsofsurgery/Abstract/2022/01000/Intravenous_Local_Anesthetic_Compared_With.38.aspx