Is Perioperative Intravenous Lidocaine a Sufficient Adjunct to Traditional Opioid Therapy at Decreasing Post-operative Pain in Male and Female Patients Ages 18-75 Following a Laparoscopic Cholecystectomy?
Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
OBJECTIVE: The objective of this systematic review is to determine “Is perioperative intravenous lidocaine a sufficient adjunct to traditional opioid therapy at decreasing post operative pain in male and female patients ages 18-75 following a laparoscopic cholecystectomy?”
STUDY DESIGN: A review of three randomized control trials (RCTs) that were peer reviewed and published in English after 2015.
DATA SOURCE: All articles were published in peer reviewed journals and were researched using PubMed and EBSCO databases. Studies were selected based on their ability to answer the question posed in the objective, and if the researched outcomes were patient oriented.
OUTCOMES: The outcome assessed was the reduction in post-operative pain scores during the studies. Pain scores were recorded using visual analogue scales or visual numerical scales.
RESULTS: One out of the three studies have found that lidocaine is a sufficient adjunct to traditional opioid therapy at reducing post-operative pain scores in patients following laparoscopic cholecystectomies. Song et al. (2017) showed significant data at 2 hours postoperation for the mean pain scores of the lidocaine group and placebo group (lidocaine 3.01 ±0.65 vs. placebo 4.27 ±0.58, p = 0.01). However, studies by Ortiz et al. (2016) and Bajracharya et al. (2019) found non-significant data. Ortiz et al. found that at 2 hours post-operation mean scores between the two groups were (lidocaine 2.57 ± 2.31 vs. placebo 2.14 ± 1.73, p = 0.50). The study by Bajracharya et al. concluded that the mean score for the lidocaine group was 1.8 and the esmolol group was 1.6. No p-value was calculated at 2-hours post-operation for this study but the overall p-value at the end of the study was non-significant (p = 0.38).
CONCLUSIONS: The results of these three studies revealed that it remains unknown if lidocaine is a beneficial adjunct to traditional opioid therapy at decreasing post-operative pain in patients following laparoscopic cholecystectomies. More research is needed to determine the optimal dosing and infusion rate to administer during the procedures.
Malacusky, Desiree, "Is Perioperative Intravenous Lidocaine a Sufficient Adjunct to
Traditional Opioid Therapy at Decreasing Post-operative Pain in
Male and Female Patients Ages 18-75 Following a Laparoscopic
Cholecystectomy?" (2022). PCOM Physician Assistant Studies Student Scholarship. 631.