Use of IV Lidocaine Infusion Postoperatively Within the ERAS Surgical Population

Abstract

Purpose: The aim of this project was to investigate whether opioid pain scores, postoperative opioid requirements, and postanesthesia care unit (PACU) length of stay were impacted when comparing a 24-hour intravenous lidocaine infusion versus postoperative discontinuation of the lidocaine infusion.

Design: A retrospective chart review was used both before and after the discontinuation of postoperative lidocaine infusions for a quality improvement project.

Methods: The project was carried out in the adult surgery PACU setting at a level 1 trauma center between April 2021 and September 2021. The sample included 100 adult patients who fell under surgical specialties that used enhanced recovery after surgery protocol. After approval was obtained, data was collected via an electronic chart review using an evaluation tool created by the project team.

Findings: Between the five surgical specialties used for this review, the PACU length of stay variable was reduced only in the gynecology oncology service (P= .041). Additionally, the postoperative opioid requirements were significantly reduced in the surgical oncology service (P = .02). Comparing the groups as a whole, 50 participants who had a 24-hour continuous lidocaine infusion and 50 participants whose lidocaine infusion was discontinued before PACU admission had no statistically significant values with pain scores, postoperative opioid requirements, and PACU length of stay.

Conclusions: Results indicate that a 24-hour lidocaine infusion did not impact this patient population's pain scores, postoperative opioid requirements, or PACU length of stay.

Keywords: ERAS; PACU phase 1; anesthesia; lidocaine; opioids; pain.