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Attenuation of Pneumoperitoneum-Induced Hypertension by Intraoperative Lidocaine Infusion in Laparoscopic Cholecystectomy

Background: Laparoscopy has now become the standard technique and is considered gold standard for cholecystectomy but the intraoperative requirements of laparoscopic surgery produce significant physiological changes, which pose many challenges for the anesthesiologist. Objective: The aim of this work was to evaluate the effect of intraoperative IV lidocaine infusion for attenuation of pneumoperitoneum-induced hypertension. Patients and Methods: After approval of the Medical Ethical Committee at Al-Azhar University Hospitals, Department of Anesthesia, and after patient written consent, 90 patients of American Society of Anesthesiologists (ASA) physical status I or II, scheduled for laparoscopic cholecystectomy were enrolled in this randomized, controlled, prospective, double-blind, clinical trial study. Results: Regarding the intraoperative and postoperative hemodynamics, in the present study it was observed that patients who received intravenous lidocaine (1.5 mg/kg bolus before skin incision and abdominal inflation followed by 1 mg/kg/h or 2 mg/kg/h and stopped immediately after abdominal deflation) were associated with a reduction in intraoperative BP and HR without any associated hemodynamic instability in comparison to patients who did not received lidocaine with no statistically significant difference between the two doses of lidocaine. Conclusion: This study showed that the intraoperative infusion of lidocaine of two different doses in patients undergoing laparoscopic cholecystectomy was associated with attenuation of blood pressure, heart rate, decreases the intensity of postoperative pain, and early recovery of bowel function without causing significant adverse effects, with more satisfaction for both patients and surgeons.