Lidocaine infusion with enhanced recovery program protocol for pancreatic cancer surgery: effect on postoperative pain and patient immunity
Background Enhanced Recovery After Surgery (ERAS) has been established in various surgical specialties. This prospective controlled randomized study was intended to assess the efficacy of implementing intravenous lidocaine infusion with enhanced recovery after pancreatic surgery (ERAPS) program on p...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Alexandria Journal of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20905068.2024.2409573 |
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| author | Alaa Elsayed Ghoneim Emad Abdelmoneim Arida Sahar Ahmed El-Karadawy Ashraf Arafat Abdelhalim Mohamed Samir Kamel Wessam Zakaria EL-Amrawy |
| author_facet | Alaa Elsayed Ghoneim Emad Abdelmoneim Arida Sahar Ahmed El-Karadawy Ashraf Arafat Abdelhalim Mohamed Samir Kamel Wessam Zakaria EL-Amrawy |
| author_sort | Alaa Elsayed Ghoneim |
| collection | DOAJ |
| description | Background Enhanced Recovery After Surgery (ERAS) has been established in various surgical specialties. This prospective controlled randomized study was intended to assess the efficacy of implementing intravenous lidocaine infusion with enhanced recovery after pancreatic surgery (ERAPS) program on postoperative patients’ outcomes.Methods Thirty patients aged 30 to 70 years, of ASA class II who underwent elective pancreatic cancer surgery under general anesthesia were divided into two equal groups, Group L received IV lidocaine infusion, and Group S received IV saline. Postoperative pain intensity was our primary outcome, total postoperative epidural bupivacaine consumption, hospital stay, gastro-intestinal recovery, time to first ambulation, hospital stay duration, effect on immune response and perioperative complications were secondary outcomes.Results The visual analog scale (VAS) scores for pain were significantly lower in Group L compared with those in Groups S (p < 0.05). Post-operative epidural bupivacaine consumption, time to first patient ambulation, food intake and return of bowel movement were significantly less in Group L (p < 0.05%). There were no significant differences between groups in times to pass first flatus, first defecation, length of hospital stay (p > 0.05). Natural killer cell isolation and cytotoxic lymphocytes count decreased in both studied groups postoperatively in comparison to preoperative value and this reduction was significantly detected in Group S when compared with Group L (p = 0.001). The function of natural killer cell and cytotoxic lymphocytes with or without stimulation enhanced in Group L while it suppressed in Group S postoperatively in comparison to preoperative reading and significant difference was recorded between the two groups (p = 0.001).Conclusion Implementation of lidocaine in ERAS protocol in patients with cancer pancreas undergoing pancreatic surgery decreased pain score, reduced post-operative epidural bupivacaine consumption, shortened time to return of bowel sound, and enhanced patient ambulation and the patient’s immunity. |
| format | Article |
| id | doaj-art-1f096c8a585e4e96a9f1757dfd27cac7 |
| institution | Kabale University |
| issn | 2090-5068 2090-5076 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Alexandria Journal of Medicine |
| spelling | doaj-art-1f096c8a585e4e96a9f1757dfd27cac72024-11-22T08:38:07ZengTaylor & Francis GroupAlexandria Journal of Medicine2090-50682090-50762024-12-0160136337010.1080/20905068.2024.2409573Lidocaine infusion with enhanced recovery program protocol for pancreatic cancer surgery: effect on postoperative pain and patient immunityAlaa Elsayed Ghoneim0Emad Abdelmoneim Arida1Sahar Ahmed El-Karadawy2Ashraf Arafat Abdelhalim3Mohamed Samir Kamel4Wessam Zakaria EL-Amrawy5Department of Anesthesia and Pain Management, Medical Research Institute, Alexandria University, Alexandria, EgyptDepartment of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, EgyptDepartment of Anesthesia and Pain Management, Medical Research Institute, Alexandria University, Alexandria, EgyptDepartment of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, EgyptDepartment of Experimental and Clinical Surgery, Medical Research Institute, Alexandria University, Alexandria, EgyptDepartment of Anesthesia and Pain Management, Medical Research Institute, Alexandria University, Alexandria, EgyptBackground Enhanced Recovery After Surgery (ERAS) has been established in various surgical specialties. This prospective controlled randomized study was intended to assess the efficacy of implementing intravenous lidocaine infusion with enhanced recovery after pancreatic surgery (ERAPS) program on postoperative patients’ outcomes.Methods Thirty patients aged 30 to 70 years, of ASA class II who underwent elective pancreatic cancer surgery under general anesthesia were divided into two equal groups, Group L received IV lidocaine infusion, and Group S received IV saline. Postoperative pain intensity was our primary outcome, total postoperative epidural bupivacaine consumption, hospital stay, gastro-intestinal recovery, time to first ambulation, hospital stay duration, effect on immune response and perioperative complications were secondary outcomes.Results The visual analog scale (VAS) scores for pain were significantly lower in Group L compared with those in Groups S (p < 0.05). Post-operative epidural bupivacaine consumption, time to first patient ambulation, food intake and return of bowel movement were significantly less in Group L (p < 0.05%). There were no significant differences between groups in times to pass first flatus, first defecation, length of hospital stay (p > 0.05). Natural killer cell isolation and cytotoxic lymphocytes count decreased in both studied groups postoperatively in comparison to preoperative value and this reduction was significantly detected in Group S when compared with Group L (p = 0.001). The function of natural killer cell and cytotoxic lymphocytes with or without stimulation enhanced in Group L while it suppressed in Group S postoperatively in comparison to preoperative reading and significant difference was recorded between the two groups (p = 0.001).Conclusion Implementation of lidocaine in ERAS protocol in patients with cancer pancreas undergoing pancreatic surgery decreased pain score, reduced post-operative epidural bupivacaine consumption, shortened time to return of bowel sound, and enhanced patient ambulation and the patient’s immunity.https://www.tandfonline.com/doi/10.1080/20905068.2024.2409573Lidocaineenhanced recovery after surgerypancreatic cancerpainimmunity |
| spellingShingle | Alaa Elsayed Ghoneim Emad Abdelmoneim Arida Sahar Ahmed El-Karadawy Ashraf Arafat Abdelhalim Mohamed Samir Kamel Wessam Zakaria EL-Amrawy Lidocaine infusion with enhanced recovery program protocol for pancreatic cancer surgery: effect on postoperative pain and patient immunity Alexandria Journal of Medicine Lidocaine enhanced recovery after surgery pancreatic cancer pain immunity |
| title | Lidocaine infusion with enhanced recovery program protocol for pancreatic cancer surgery: effect on postoperative pain and patient immunity |
| title_full | Lidocaine infusion with enhanced recovery program protocol for pancreatic cancer surgery: effect on postoperative pain and patient immunity |
| title_fullStr | Lidocaine infusion with enhanced recovery program protocol for pancreatic cancer surgery: effect on postoperative pain and patient immunity |
| title_full_unstemmed | Lidocaine infusion with enhanced recovery program protocol for pancreatic cancer surgery: effect on postoperative pain and patient immunity |
| title_short | Lidocaine infusion with enhanced recovery program protocol for pancreatic cancer surgery: effect on postoperative pain and patient immunity |
| title_sort | lidocaine infusion with enhanced recovery program protocol for pancreatic cancer surgery effect on postoperative pain and patient immunity |
| topic | Lidocaine enhanced recovery after surgery pancreatic cancer pain immunity |
| url | https://www.tandfonline.com/doi/10.1080/20905068.2024.2409573 |
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