Lidocaine infusion of no help in gut function recovery after colon resection

Perioperative administration of 2% intravenous lidocaine does not appear to have any positive impact on gut function recovery in patients who undergo elective minimally invasive colon resection, according to a study.

The study included 590 adults who were scheduled for elective minimally invasive colon resection for benign or malignant disease. These patients were randomly allocated to either the lidocaine or placebo group. Participants in the lidocaine group received 2% lidocaine infusion, administered as 1.5-mg/kg bolus at induction of anaesthesia followed by 1.5 mg/kg/h for 6 or 12 hours. Those in the control group received 0.9% saline placebo for 6 or 12 hours.

The primary outcome was return of gut function at 72 hours after surgery, defined by the GI-3 composite endpoint of tolerating diet (ingestion of food and drink without significant nausea or vomiting for 3 consecutive meals) and passage of flatus or stool. Secondary outcomes included time to GI-3 recovery, time to GI-2 recovery (tolerance of oral diet and passage of stool), prolonged postoperative ileus, postoperative nausea and vomiting score, Overall Benefit of Analgesia Score, postoperative opioid consumption, Quality of Recovery–15, quality of life (EuroQol 5-Dimension 5-Level), enhanced recovery protocol adherence, time to meeting medically defined criteria for discharge, and time to patient self-assessed readiness for discharge.

Of the participants, 557 (mean age 66 years, 44.7 percent female) were included in the analysis, including 279 in the lidocaine group and 278 in the placebo group.

The percentage of participants who had their gut function return at 72 hours did not significantly differ between the lidocaine group and the placebo group (57.3 percent vs 59.0 percent; adjusted absolute difference, −1.9 percent, 95 percent confidence interval [CI], −8.0 to 4.2; relative risk, 0.97, 95 percent CI, 0.88–1.07).

Likewise, no significant difference in any of the secondary endpoints was observed between the lidocaine and control groups.