The Effect of Intravenous Lidocaine Infusion on Post-Operative Pain after Percutaneous Nephro Lithotomy: A Randomized Clinical Trial

Abstract

Background: Percutaneous Nephro Lithotomy (PCNL) is an efficient treatment for complicated, large and staghorn calculi. Optimal pain control has long been a concern for the surgeons and the anesthesiologist. The pivotal aim of this study is to evaluate the effects of intravenous lidocaine infusion on pain levels, sedation score, foley catheter tolerance and level of nausea and vomiting in patients undergoing the procedure. Methods: In a randomized parallel group double blind clinical trial, 60 patients with ASA physical class I candidate for PCNL were enrolled in the study. During the operation, group A patients received 1mg/kg/hr infusion of intravenous lidocaine infusion while group B patients received normal saline infusion as placebo. Results: Patients receiving lidocaine infusion had better foley catheter tolerance compared to the placebo group. Similarly VAS pain scores in the PACU were 2.5 ± 1.7 in group A versus 3.7 ± 1.2 in group B was observed to be higher in the placebo group leading to significant difference. (p= 0.03) One hour after surgery 4 (23%) and 26 (87%) of the patients in group A were drowsy and alert, while the results in group B were 13 (77%) and 6 (20%) respectively. Conclusion: The results of our study demonstrates significant difference in sedation score (15 minutes and one hour after surgery) and foley catheter tolerance in patients who received lidocaine infusion through PCNL surgery. In addition, patients receiving lidocaine infusion convey better pain scores after surgery.

Keywords

• acute pain
• lidocaine
• post-operative
• percutaneous nephrostomy