Influence of dexmedetomidine and lidocaine on perioperative opioid consumption in laparoscopic intestine resection: a randomized controlled clinical trial

J Int Med Res. 2018 Dec;46(12):5143-5154. doi: 10.1177/0300060518792456. Epub 2018 Sep 13.

Abstract

Objective: The consumption of opioid analgesics could be reduced by the use of analgesics with different mechanisms of action. We investigated whether additional treatment with dexmedetomidine or lidocaine could reduce opioid consumption.

Methods: We randomized 59 study participants into three groups and examined: (i) fentanyl consumption, (ii) consumption of piritramide, and (iii) cognitive function and neuropathic pain. The control group received continuous propofol infusion and fentanyl boluses. Continuous intravenous infusion of dexmedetomidine (0.5 µg/kg/h) was administered to the dexmedetomidine group and lidocaine (1.5 mg/kg/h) was administered to the lidocaine group.

Results: No reduction in fentanyl consumption was observed among the groups. However, we noted a significantly lower consumption of piritramide on the first and second postoperative day in the lidocaine group. Total consumption of piritramide was significantly lower in the lidocaine group compared with the control group.

Conclusions: Lidocaine and dexmedetomidine reduced intraoperative propofol consumption, while lidocaine reduced postoperative piritramide consumption. Clinical trial registration: NCT02616523.

Keywords: Analgesia; cognitive function; dexmedetomidine; laparoscopy; lidocaine; neuralgia.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Non-Narcotic / administration & dosage
  • Analgesics, Opioid / administration & dosage*
  • Anesthetics, Local / administration & dosage
  • Dexmedetomidine / administration & dosage*
  • Female
  • Humans
  • Intestinal Neoplasms / surgery*
  • Laparoscopy / adverse effects*
  • Lidocaine / administration & dosage*
  • Male
  • Middle Aged
  • Opioid-Related Disorders / prevention & control
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / etiology
  • Perioperative Care*
  • Prognosis

Substances

  • Analgesics, Non-Narcotic
  • Analgesics, Opioid
  • Anesthetics, Local
  • Dexmedetomidine
  • Lidocaine

Associated data

  • ClinicalTrials.gov/NCT02616523