Intraoperative Lidocaine Infusion for Analgesia (ILIA)
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Purpose
The purpose of this study is to evaluate the efficacy of intravenous lidocaine infusion administered during general anesthesia in:
- Reducing length of hospital stay following total abdominal hysterectomy
- Reducing postoperative analgesic requirement following total abdominal hysterectomy.
Hypothesis:
The addition of an intraoperative lidocaine infusion to a balanced anesthetic technique will result in up to 50% of patients being discharged after postoperative day 2 compared with the current 21%. Also, it will result in a 30% reduction in opiod consumption during the first 48 hours following total abdominal hysterectomy.
Assumption:
Patients in the intervention and control groups will be titrated to approximately equal analgesia because they will self-administer enough pain-controlling medications to make their postoperative pain experience the same.
Primary outcomes:
- Length of hospital stay
- Total opioid use at 48 hours postoperatively
Secondary outcomes. The following data will be collected and analyzed:
- Intraoperative data: BIS scores (to control depth of anesthesia); intraoperative serum lidocaine levels; intraoperative opioid use
- Opioid use in the recovery room
- Patient Controlled Analgesia (PCA) morphine requirements postoperatively up to 48 hours
- Oral pain controlling medication use up to 48 hours postoperatively if IV PCA discontinued before 48 hours
- Verbal Analogue Scale (VAS) pain scores in recovery room and during first 2 days post-operatively
- Incidence of side effects that can be attributed to local anesthetic toxicity
- Incidence of nausea and vomiting and anti-emetic use up to 48 hours postoperatively
- Time of first flatus and first bowel movement.
| Condition | Intervention |
|---|---|
|
Elective Total or Subtotal Abdominal Hysterectomy |
Drug: Lidocaine Intravenous Infusion |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Prospective Evaluation of the Addition of Intraoperative Intravenous Lidocaine Infusion to General Anesthetic in Total Abdominal Hysterectomy. |
- Length of hospital stay
- Total opioid use at 48 hours postoperatively
- Intraoperative data: BIS scores (to control depth of anesthesia)
- Intraoperative serum lidocaine levels
- Intraoperative opioid use
- Opioid use in the recovery room
- Patient Controlled Analgesia (PCA) morphine requirements postoperatively up to 48 hours;
- Oral pain controlling medication use up to 48 hours postoperatively if IV PCA discontinued before 48 hours;
- Verbal Analogue Scale (VAS) pain scores in recovery room and during first 2 days post-operatively;
- Incidence of side effects that can be attributed to local anesthetic toxicity;
- Incidence of nausea and vomiting and anti-emetic use up to 48 hours postoperatively;
- Time of first flatus and first bowel movement.
| Enrollment: | 93 |
| Study Start Date: | November 2006 |
| Study Completion Date: | December 2008 |
| Primary Completion Date: | December 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Lidocaine
IV lidocaine in OR as described in methods
|
Drug: Lidocaine Intravenous Infusion
1.5 mg/kg IV bolus on induction, 3 mg/kg/hr infusion from inducation until fascia closure
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 30 Years to 70 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients undergoing elective total abdominal hysterectomy at The Ottawa Hospital and able to give informed consent.
Plus:
- Age 30-69 inclusive;
- ASA (American Society of Anesthesiologists) class I or II patient: (I - healthy with no systemic disease, II - systemic disease with no functional limitation);
- Body Mass Index (BMI) of 18.5-30.
Exclusion Criteria:
Patients undergoing elective total abdominal hysterectomy at The Ottawa Hospital and unable to give informed consent., unable to provide informed consent, or unable to use patient controlled analgesia.
Plus:
- Patients under age 30 or over age 70;
- ASA III, IV and V class patients (III - systemic disease causing functional impairment; IV - systemic disease that is a constant threat to life; V - not expected to survive with or without surgery);
- Obese patients (BMI>30) or undernourished (BMI<18.5) (9);
- Unable to use patient controlled analgesia;
- Any history of liver dysfunction;
- Renal insufficiency defined as a creatinine clearance <50mL/min as calculated using the Cockroft-Gault formula (11);
- History of seizure disorder;
- Hypersensitivity or allergy to amide type local anesthetics;
- Hypersensitivity or allergy to any of the following opiods: morphine, hydromorphone, meperidine, fentanyl;
- Any chronic pain syndromes or opioid use greater than once per week.
Contacts and Locations| Canada, Ontario | |
| The Ottawa Hospital | |
| Ottawa, Ontario, Canada, K1H 8L6 | |
| Principal Investigator: | ILIA Charapov, MD | The Ottawa Hospital, Dept of Anesthesia |
| Study Chair: | Greg Bryson, MD | The Ottawa Hospital, Dept of Anesthesia |
More Information
No publications provided by University of Ottawa
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Dr. ILIA Charapov, University of Ottawa, Departmet of Anesthesiology |
| ClinicalTrials.gov Identifier: | NCT00382499 History of Changes |
| Other Study ID Numbers: | #2006512-01H |
| Study First Received: | September 28, 2006 |
| Last Updated: | September 9, 2009 |
| Health Authority: | Canada: Health Canada |
Keywords provided by University of Ottawa:
|
Intravenous Lidocaine Lidocaine Infusion Total Abdominal Hysterectomy |
Analgesia Anesthesia Adjunct |
Additional relevant MeSH terms:
|
Anesthetics, General Lidocaine Anesthetics Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents |
Therapeutic Uses Anesthetics, Local Sensory System Agents Peripheral Nervous System Agents Anti-Arrhythmia Agents Cardiovascular Agents |
ClinicalTrials.gov processed this record on June 13, 2013