Analgesic efficacy of intravenous perfusion of lidocaine, ketamine or a combination after laparotomy in a placebo-controlled, randomized, double-blind prospective study

Détails

Ressource 1Télécharger: BIB_73E9F0C0814F.P001.pdf (756.44 [Ko])
Etat: Serval
Version: Après imprimatur
ID Serval
serval:BIB_73E9F0C0814F
Type
Thèse: thèse de doctorat.
Collection
Publications
Titre
Analgesic efficacy of intravenous perfusion of lidocaine, ketamine or a combination after laparotomy in a placebo-controlled, randomized, double-blind prospective study
Auteur(s)
Joray F.
Directeur(s)
Kern  C.
Codirecteur(s)
Decosterd  I., Gardaz  J.-P.
Institution
Université de Lausanne, Faculté de biologie et médecine
Adresse
Faculté de biologie et de médecine Université de Lausanne UNIL - Bugnon Rue du Bugnon 21 - bureau 4111 CH-1015 Lausanne SUISSE
Statut éditorial
Acceptée
Date de publication
2011
Langue
anglais
Nombre de pages
26
Résumé
In acute postoperative pain management intravenous lidocaine and/or ketamine have been advocated because of their morphine-sparing effect.
The goal of this prospective, randomised, double-blind study was to assess morphine consumption with different regimens of intravenous infusion of lidocaine, ketamine or both during 48 hours following laparotomy. Patients were randomised into four groups. Group L, K, and KL received intravenous lidocaine, ketamine or a combination, respectively, before incision and during 48 hours postoperatively. The control group (C) received a similar volume of saline bolus and infusion. Postoperative analgesia included morphine delivered by a patient-controlled analgesia device. Primary outcome was the cumulative morphine consumption and pain, sedation scores, pressure algometry and side effects were our secondary outcomes. Cognition and psychomotor performance were also tested.
Out of 57 eligible patients, 44 completed the study. Lidocaine reduced the cumulative morphine consumption compared with the control group (mean 0.456 mg.kg-1 +/- 0.244 (SD) versus 0.705 +/- 0.442, respectively, Ρ < 0.001). Pain scores during movement were statistically lower in all three treatment groups. Psychometric tests showed that the lidocaine group expressed more depressed feelings and sadness compared to the control group.
Lidocaine administration had a morphine-sparing effect with a 36% reduction of morphine consumption while ketamine alone or combined with lidocaine did not. As a whole, our results suggest that intravenous lidocaine may offer advantages for postoperative analgesia. We propose lidocaine as a new alternative for pain control that needs to be studied further in future multicentric studies.
Création de la notice
11/09/2012 12:07
Dernière modification de la notice
03/03/2018 18:20
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