Effects of Intraoperative Lignocaine Infusion on Heamodynamics and Postoperative Analgesic Requirement after Day Case Laparoscopic Surgery
Abstract
Background: Intravenous lignocaine is an amide local
anaesthetic known for its analgesic, anti-hyperalgesic, antiinflammatory
and anti-arrhythmic properties. During
perioperative period of laparoscopic surgeries haemodynamic
alteration occurs due to laryngoscopy, intubation, and
surgical excision, gas insufflation during pneumoperitoneum,
inadequate analgesia and inadequate depth of
anaesthesia. Intravenous lignocaine is often administered
to suppress the haemodynamic response and as an analgesic
agent. We aimed to evaluate the effect of intravenous infusion
of lignocaine on haemodynamic response and post-operative
analgesic requirement.
Objectives: The purpose of this study was to evaluate the
effect of intravenous infusion of lignocaine on
haemodynamic and postoperative analgesic requirements
after laparoscopic day case surgeries.
Material and method: Four hundred Sixty (460) patients
were selected who’s were going to be operated for laparoscopic
surgeries (Laparoscopic Cholecystectomy, laparoscopic
Hernioplasty, laparoscopic appendicectomy, Diagnostic
laparoscopy due to infertility) were grouped into exposed
(Group L) who were received lignocaine infusion @1mg/
kg/hr and controlled (Group C) who were received placebo.
Systematic random sampling was employed.
Results: Demographic characteristics were comparable between
the groups p>0.05. In lignocaine group intraoperative mean
systolic blood pressure, mean diastolic blood pressure, mean
arterial blood pressure and mean heart rate were significantly
lower than control group (p<0.05). Twenty four hour mean
VAS score (0 – 10 cm) at immediate recovery, 1st, 2nd, 3rd, 6th,
12th and 24th hour were lower in lignocaine group (p<0.05).
The mean time of first analgesic requirement were longer
(120 minutes) in lignocaine group compared to 40 minutes in
control group (p<0.001) and the mean total tramadol
consumption is less in lignocaine group (p<0.001).
Conclusion: Intra operative lignocaine infusion causes more
haemodynamic stability and decreases postoperative pain
score, required longer time for first analgesic requirement
and reduced total analgesic consumption in laparoscopic
surgeries.