Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.015
Brazilian Journal of Anesthesiology
Clinical Research

Effect of intravenous lidocaine on short-term pain after hysteroscopy: a randomized clinical trial

Efeito da lidocaína intravenosa na dor de curto prazo após histeroscopia: um ensaio clínico randomizado

Xuan Peng, Yuzi Zhao, Yeda Xiao, Liying Zhan, Huaxin Wang

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Abstract

Background
The role of intravenous lidocaine infusion in endoscopic surgery has been previously evaluated for pain relief and recovery. Recently, it has been shown to reduce postoperative pain and opioid in patients undergoing endoscopic submucosal dissection. Similar to endoscopic submucosal dissection, operative hysteroscopy is also an endoscopic surgical procedure within natural lumens. The present study was a randomized clinical trial in which we evaluated whether intravenous lidocaine infusion would reduce postoperative pain in patients undergoing hysteroscopic surgery.

Objective
To evaluate whether intravenous lidocaine infusion could reduce postoperative pain in patients undergoing operative hysteroscopy.

Methods
Eighty-five patients scheduled to undergo elective hysteroscopy were randomized to receive either an intravenous bolus of lidocaine 1.5 mg.kg-1 over 3-minutes, followed by continuous infusion at a rate of 2 mg.kg-1. h-1 during surgery, or 0.9% normal saline solution at the same rate. The primary outcome was to evaluate postoperative pain by Visual Analog Scale (VAS). Secondary outcomes included remifentanil and propofol consumption.

Results
In the lidocaine group, the VAS was significantly lower at 0.5 h (p =  0.008) and 4h (p =  0.020). Patients in the lidocaine group required less remifentanil than patients in the control group (p <  0.001). However, there was no difference between the two groups in the propofol consumption. The incidence of throat pain was significantly lower in the lidocaine group (p =  0.019). No adverse events associated with lidocaine infusion were discovered.

Conclusion
Intravenous lidocaine infusion as an adjuvant reduces short-term postoperative pain in patients undergoing operative hysteroscopy.

Keywords

Anesthesia;  Hysteroscopy;  Lidocaine;  Postoperative pain;  Propofol

Resumo

Introdução: O papel da infusão intravenosa de lidocaína na cirurgia endoscópica foi avaliado anteriormente para o alívio e recuperação da dor. Recentemente, demonstrou reduzir a dor pós-operatória e os opioides em pacientes submetidos à dissecção endoscópica da submucosa. Semelhante à dissecção endoscópica da submucosa, a histeroscopia operatória também é um procedimento cirúrgico endoscópico em lúmens naturais. O presente estudo foi um ensaio clínico randomizado no qual avaliamos se a infusão intravenosa de lidocaína reduziria a dor pós-operatória em pacientes submetidas à cirurgia histeroscópica. Objetivo: Avaliar se a infusão intravenosa de lidocaína pode reduzir a dor pós-operatória em pacientes submetidas à histeroscopia operatória. Métodos: Oitenta e cinco pacientes programadas para serem submetidas à histeroscopia eletiva foram randomizadas para receber um bolus intravenoso de lidocaína 1,5 mg / kg por 3 minutos, seguido por infusão contínua a uma taxa de 2 mg / kg / h durante a cirurgia, ou 0,9% normal solução salina na mesma taxa. O desfecho primário foi avaliar a dor pós-operatória pela Escala Visual Analógica (VAS). Os desfechos secundários incluíram o consumo de remifentanil e propofol. Resultados: No grupo lidocaína, a VAS foi significativamente menor em 0,5 h (p = 0,008) e 4 h (p = 0,020). Os pacientes do grupo lidocaína necessitaram de menos remifentanil do que os pacientes do grupo controle (p <0,001). No entanto, não houve diferença entre os dois grupos no consumo de propofol. A incidência de dor de garganta foi significativamente menor no grupo lidocaína (p = 0,019). Nenhum evento adverso associado à infusão de lidocaína foi descoberto. Conclusão: A infusão intravenosa de lidocaína como adjuvante reduz a dor pós-operatória de curto prazo em pacientes submetidas à histeroscopia cirúrgica.

Palavras-chave

Anestesia; Histeroscopia; Lidocaína; Dor pós-operatória; Propofol.

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