Systemic Lidocaine Decreased the Perioperative Opioid Analgesic Requirements but Failed to Reduce Discharge Time After Ambulatory Surgery

Perioperative systemic lidocaine significantly reduces opioid requirements in the ambulatory setting without affecting time to discharge.

Postoperative pain is the most common reason for delay in discharge and unplanned hospital admission after ambulatory surgery.1–3

Because postoperative pain is to a large extent an inflammatory phenomenon, administration of systemic local anesthetics, which have inflammatory modulatory properties,4 could significantly reduce pain and therefore allow more rapid discharge.5 Lidocaine has an excellent safety record when administered by low-dose infusion.5–7 However, whereas decreased hospital stay after inpatient surgery has been demonstrated, the effect of intraoperative and early postoperative lidocaine infusion on duration of stay after ambulatory surgery is not known. Although it seems logical that decreased pain would allow earlier discharge, it is conceivable that, e.g., mild sedating effects of lidocaine could prolong postanesthesia care unit (PACU) admission and interfere with discharge.

We hypothesized that lidocaine, when administered systemically during the operative and early postoperative period, would decrease length of PACU stay (primary outcome measure). Secondary outcome measures were postoperative pain, opioid requirements, and postoperative nausea and vomiting. 

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