A RECENT study has demonstrated that intravenous lidocaine can significantly reduce catheter-related bladder discomfort (CRBD) and postoperative pain in patients undergoing complex lumbar spinal surgery. The research focused on male patients aged between 20–79 who underwent elective spine fusion surgery involving at least two levels.
Eighty participants were randomly divided into two groups: one group received intravenous lidocaine (1.5 mg/kg followed by 2 mg/kg/h), while the other group was administered a parallel volume of normal saline. The primary aim was to compare the incidence of moderate-to-severe CRBD in a post-anaesthetic care unit between the two groups. Secondary outcomes included levels of postoperative pain, opioid usage over 24 hours, CRBD intensity at various intervals of 1-, 2-, 6- and 24-hours post-surgery, patient satisfaction, and any adverse effects or surgical complications.
The findings revealed that the group treated with lidocaine experienced a markedly lower incidence of moderate-to-severe CRBD in the post-anaesthetic care unit (P=0.002) and at 1-hour post-surgery (P=0.039) compared to the control group. Pain levels were also significantly lower in the lidocaine group at every measured time point (P<0.001, P<0.001, P=0.001, P<0.001, and P<0.001 at 0, 1, 2, 6, and 24 hours, respectively). Furthermore, patients in this group required less postoperative morphine (P<0.05) and reported higher satisfaction scores on the Global Perceived Effect Scale (GPES) (P<0.001). Importantly, no adverse effects or surgical complications were reported in either group.
The study concludes that intravenous lidocaine offers significant benefits in reducing CRBD and postoperative pain while enhancing patient satisfaction in complex spinal surgeries, without introducing additional risks.
Katheeja Imani, EMJ
Reference
Chantrapannik E et al. Effect of intravenous lidocaine on catheter‑related bladder discomfort, postoperative pain and opioid requirement in complex fusion lumbar spinal surgery: a randomized, double blind, controlled trial. BMC Anesthesiology. 2024;24(1):405.
