Intraoperative lignocaine infusion achieving earlier discharge criteria among laparoscopic cholecystectomy patients

Abstract

Background: Laparoscopic cholecystectomy (LC), gaining worldwide popularity for being less invasive, enhances earlier recovery. It can be performed on a short stay basis, reducing health care burden, if postoperative pain is adequately addressed. The aim of the present study is to determine the effect of intraoperative infusion of intravenous (IV) lignocaine primarily in terms of time to achieve fast-track eligibility (White Song score 12 out of 14) and postoperative analgesia in patients undergoing LC. Materials and Methods: A total of 120 ASAPS 1 and 2 patients undergoing elective LC were included in this randomized, prospective, placebo-controlled clinical study. Patients were allocated into two groups to receive intraoperative IV lignocaine (Group L) or normal saline (Group C). Lignocaine bolus dose 1.5 mg/kg was administered over a period of 5 min before induction followed by continuous IV infusion 3 mg/kg/h until extubation. Postoperative fentanyl requirement (during the first 6 postoperative hours) and fast-track eligibility (time to reach White Song score 12 out of 14) were recorded. Results: Time to achieve White Song score 12 out of 14 was found to be earlier in Group L (19.9 ± 3.6 min vs. 22.9 ± 2.9 min, P < 0.001). Postoperative requirement of fentanyl was significantly lower (99.3 ± 29.8 μg in Group L compared to 133 ± 35.9 μg in Group C, P < 0.001) in patients of lignocaine group. Conclusion: IV lignocaine effectively improves recovery and reduces postoperative fentanyl requirement, thereby is an inexpensive and safe method of postoperative analgesia.