The effect of intravenous lignocaine infusion on intraoperative desflurane requirement: A randomised controlled trial

Perioperative intravenous (IV) lignocaine infusion has a minimum alveolar concentration sparing effect, and this study was designed to investigate the impact of IV lignocaine infusion on the intraoperative end-tidal desflurane (Et-Des) concentration required to maintain the Bispectral Index Scale (BIS) values between 40 and 60.

Forty-eight patients were recruited for laparoscopic cholecystectomy, appendicectomy, or ovarian cystectomy. They were randomly assigned to Group A, who received a bolus of 1.5 mg kg⁻1 of 2% lignocaine hydrochloride over 3 minutes, followed by an IV infusion of 1 mg kg⁻1 h⁻1 until skin closure, and Group B, who received an equal volume of normal saline. Baseline BIS values, heart rate, and mean arterial pressure were recorded before induction of anesthesia and subsequently every 10 minutes until skin closure. Et-Des concentration, hemodynamic changes, BIS, minimum alveolar concentration, the dose of fentanyl administered, and the amount and cost of desflurane used between the 2 groups were analyzed.

Et-Des concentration in Group A (4.3% ± 0.45%) was significantly lower than in Group B (5.3% ± 0.56%, P < .001). The cost of desflurane was significantly reduced in Group A than in Group B (Ringgit Malaysia: 35.79 ± 7.43 vs Ringgit Malaysia: 46.37 ± 9.75, P < .001). Both groups' heart rate and mean arterial pressure showed no significant differences (P  = .484 and 0.619, respectively).

Intravenous lignocaine infusion reduces the Et-Des concentration, amount, and cost required to maintain the BIS value at 40 to 60 without significant hemodynamic changes or side effects in laparoscopic abdominal surgery. The usage of intravenous lignocaine infusion as adjunct to anesthesia is feasible to reduce anesthetic agent requirement.