Yon, J.H., Choi, G.J., Kang, H., Park, J.M., & Yang, H.S. (2014). Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal gastrectomy: A prospective, randomized, double-blind, placebo-controlled study. Canadian Journal of Surgery, 57, 175–182. 

To assess the effect of intravenous lidocaine infusion in patients who received a subtotal gastrectomy

One group of patients received an intravenous lidocaine infusion preoperatively and throughout surgery, and the other group received normal saline.

• N = 36  
• MEAN AGE = 62.8 years (range = 57–72 years)
• MALES: 63%, FEMALES: 37%
• KEY DISEASE CHARACTERISTICS: Patients undergoing subtotal gastrectomy for early gastric cancer between May 2012 and March 2013
• OTHER KEY SAMPLE CHARACTERISTICS: Patients who weighed less than 45 kg or more than 100 kg

• SITE: Single site
• SETTING TYPE: Inpatient
• LOCATION: Chung-Ang University in Seoul, Korea

• PHASE OF CARE: Active antitumor treatment

Double-blinded, placebo-controlled, randomized study

• Visual Analog Scale (VAS) for pain
• Administration frequency of patient-controlled analgesia (PCA)
• Measured amount of consumed fentanyl, postoperative nausea and vomiting, length of hospital stay, time to return to regular diet, and patient satisfaction at discharge

The VAS pain scores (p < 0.05) and administration frequency of PCA (p < 0.05) were significantly lower in the lidocaine group until 24 hours after surgery, and fentanyl consumption (p < 0.05) was significantly lower in this group until 12 hours postoperatively compared to the placebo group. The total amount of consumed fentanyl (p = 0.007) and the total administration frequency of PCA (p = 0.003) were significantly lower in the lidocaine group than the control group.

In this study, intravenous lidocaine infusion preoperatively and throughout surgery reduced pain during the postoperative period after subtotal gastrectomy.

• Small sample (< 100)
• Findings not generalizable

Nurses should be aware of the benefits of intravenous lidocaine infusion during certain surgical procedures, including subtotal gastrectomy, so they can advocate for the use of this intervention for their patients.