Acute rehabilitation program after laparoscopic colectomy using intravenous lidocaine

Area of Science:

• Surgical recovery and pain management
• Anesthesiology and critical care

Background:

• Acute rehabilitation protocols aim to enhance postoperative recovery and outcomes.
• Epidural analgesia is a common method for managing pain and facilitating recovery after surgery.

Purpose of the Study:

• To evaluate the efficacy of intravenous lidocaine infusion as an alternative to epidural analgesia within an acute rehabilitation protocol for laparoscopic colectomy.
• To determine if lidocaine infusion can accelerate postoperative recovery, reduce pain, and enable early discharge.

Main Methods:

• A prospective case series of 28 patients undergoing laparoscopic colectomy for benign pathology.
• Administration of intravenous lidocaine infusion (bolus and continuous infusion) starting before pneumoperitoneum.
• Implementation of a balanced analgesia strategy, early oral intake, enforced mobilization, and a 3-day discharge goal.

Main Results:

• Mean postoperative pain scores at rest and during mobilization were below 30 mm on a 100 mm visual analogue scale.
• The time to first flatus was 29 ± 13 hours, and the time to first defecation was 38 ± 13 hours.
• The average hospital discharge occurred at 3.0 ± 1.0 days post-surgery.

Conclusions:

• Intravenous lidocaine infusion is a viable alternative to epidural analgesia for acute rehabilitation following laparoscopic colectomy.
• This approach yields outcomes similar to those achieved with epidural analgesia, supporting its use in enhancing surgical recovery.