Can intravenous lidocaine decrease postsurgical ileus and shorten hospital stay in elective bowel surgery? A pilot study and literature review

BACKGROUND: This study examined whether systemic infusion of lidocaine, a local anesthetic with anti-inflammatory properties, can decrease surgical pain, length of postsurgical ileus, and hospital stay. METHODS: Twenty-two patients at a community hospital were randomized into 2 groups. Subjects were allocated to receive either lidocaine or a placebo infusion for the first 24 hours after surgery. RESULTS: Patients in the lidocaine group appeared to report less pain as reflected by a decrease in overall visual analogue scale pain scores 24 hours after surgery. The return of flatus after surgery was not considered significant (lidocaine 68.2 +/- 9.7 hours vs placebo 86.9 +/- 13.6 hours; P = .2802). The return of bowel movement after surgery was considered significant (lidocaine 88.3 +/- 6.08 hours vs placebo group 116 +/- 10.1 hours; P = .0286). The lidocaine group was discharged by mean day 3.76 +/- .24 versus placebo at mean day 4.93 +/- .42; P = .0277. CONCLUSIONS: Patients in the lidocaine group had bowel movements >24 hours earlier than those in the placebo group and were discharged earlier. (c) 2009 Elsevier Inc. All rights reserved.