Clinical Efficacy of Intravenous Lidocaine for Thyroidectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

• Published in: World journal of surgery Vol. 40; no. 12; pp. 2941 - 2947
• Main Authors: Choi, Geun Joo, Kang, Hyun, Ahn, Eun Jin, Oh, Jong In, Baek, Chong Wha, Jung, Yong Hun, Kim, Jin Yun
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-12-2016; Springer Nature B.V
• Subjects: Abdominal Surgery; Administration, Intravenous; Adolescent; Adult; Aged; Analgesia, Patient-Controlled; Analgesics, Opioid - therapeutic use; Anesthetics, Local - administration & dosage; C-Reactive Protein - metabolism; Cardiac Surgery; Central Neck Dissection; Double-Blind Method; Female; Fentanyl - therapeutic use; General Surgery; Humans; Lidocaine; Lidocaine - administration & dosage; Male; Medicine; Medicine & Public Health; Middle Aged; Nausea - drug therapy; Nausea - etiology; Original Scientific Report; Pain Measurement; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; Papillary Thyroid Carcinoma; Patient Satisfaction; Postoperative Nausea; Postoperative Pain; Prospective Studies; Surgery; Thoracic Surgery; Thyroidectomy - adverse effects; Vascular Surgery; Young Adult; Papillary Thyroid Carcinoma; Postoperative Pain; Central Neck Dissection; Postoperative Nausea; Lidocaine
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-016-3619-6

Background
Systemic lidocaine has analgesic and anti-inflammatory effects. The purpose of this prospective, randomized, double-blind study was to evaluate the effects of intravenous lidocaine on pain following thyroidectomy.
Methods
Fifty-eight adult patients scheduled for total thyroidectomy were randomly allocated to receive a 1.5 mg/kg lidocaine bolus followed by a 2 mg/kg/h infusion during surgery, or the same volume of normal saline (control). After thyroidectomy, we evaluated postoperative pain, nausea, fentanyl consumption, frequency of pushing the button (FPB) for patient-controlled analgesia (PCA), High-sensitivity C-reactive protein (hs-CRP) in serum, and patient satisfaction scores regarding the recovery process.
Results
Postoperative pain and nausea scores were significantly lower in the lidocaine group for the first 4 h following thyroidectomy, compared to the control group. Fentanyl consumption and FPB for the PCA were also significantly reduced in the lidocaine group for 4 h following thyroidectomy, and hs-CRP was significantly less in the lidocaine group at postoperative days 1 and 3. Furthermore, satisfaction scores were significantly higher in the lidocaine group compared to the control group.
Conclusions
Intravenous lidocaine effectively reduced postoperative pain and nausea following thyroidectomy as well as improved the quality of recovery. Trial registration number: Clinicaltrials.gov NCT01608360.