Security and efficacy of intravenous injection of lidocaine in major hepatic resection

Abstract

Objective. To determine in dynamics the blood lidocaine concentration in the patients while performing major hepatic resection with its epidural and intravenous injection for intra– and postoperative anesthesia and to estimate the toxicity potential. Materials and methods. Into the investigation 27 patients were included, to whom hepatic resection with preservation of 30 – 60% of parenchyma was done. In all the patients multicomponent intraoperative anesthesia was applied. Depending on adjuvant used, the patients were divided into two groups: the first – 7 patients, in whom intravenous lidocaine injection was applied, and the second – 20 patients, in whom multicomponent anesthesia was added by thoracic epidural anesthesia. Results. In 2 h postoperatively a tendency towards enhanced blood concentration of lidocaine was observed by 28.8% after its epidural injection, comparing with intravenous injection – 2.37 and 1.84 mcg/ml (р=0.29) accordingly without principal difference in 14 h after the operation – 2.85 and 2.62 mcg/ml (р=0.76) accordingly. In no one patient toxic life–threatening reactions were registered. Conclusion. The adjuvant application of lidocaine for intra– and postoperative anesthesia, using intravenous and epidural introduction in major hepatic resection performance, do not lead to raising of the medicinal compound concentration in the blood higher than conventional toxic content. The blood concentration of the preparation while its epidural introduction may be higher, than in intravenous introduction, witnessing in favor of secureness of intravenous application of lidocaine and at the same time a statistically significant difference between indices of its concentration in various ways of introduction was not observed.

Keywords

• multicomponent anesthesia
• intravenous injection of lidocaine
• epidural anesthesia
• extended hepatic resection