Lidocaine and Prevention of Chronic Pain

The study seeks to investigate a safe and inexpensive strategy to reduce persistent post-surgical pain that can affect up to 60% of patients undergoing surgical procedures. It also seeks to investigate specific brain changes associated with the development of chronic pain. This may lead to the development of more specific and more effective treatments.

Hypotheses:

1. Perioperative systemic lidocaine reduces the incidence of chronic pain in patients undergoing surgical procedures.
2. There is a specific brain morphological/function change associated with the development of chronic pain.

• Drug: .9 normal saline placebo
  Administration of .9 normal saline placebo as a bolus and as maintenance throughout the length of the surgical procedure.
• Drug: Group L (lidocaine)
  Group L will receive a 1.5 mg/kg bolus of intravenous lidocaine followed by a 2mg/kg/hr infusion that will be started at the time of surgical induction and will be discontinued one hour after the end of the surgical procedure.

• Active Comparator: Group L
  Group L will receive a 1.5 mg/kg bolus of intravenous lidocaine followed by a 2mg/kg/hr infusion that will be started at the time of surgical induction and will be discontinued one hour after the end of the surgical procedure.
  Intervention: Drug: Group L (lidocaine)
• Placebo Comparator: .9% normal saline placebo
  .9% normal saline administered as a bolus then as a maintenance infusion for the length of the surgical case.
  Intervention: Drug: .9 normal saline placebo

Inclusion Criteria:

• Age 18-64,
• Females undergoing gynecological, urological or breast surgery

Exclusion Criteria:

• pregnant,
• history of chronic use of opioids,
• allergy to local anesthetics,
• history of cardiac arrhythmias Drop out: patient or surgeon request