Document Type : Original Article
- Raymond Ndikontar 1, 2
- Roddy Stephan Bengono Bengono 1, 3
- Albert Ludovic Amengle 1, 2
- Joel Noutakdie Tochie 4
- Bonaventure Jemea 1, 5
- Junette Metogo Mbengono 6, 7
- Paul Owono Etoundi 1, 8
- Jacqueline Ze Minkande 1, 2
1 Department of Surgery and Sub-Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
2 Anaesthesiology and Intensive Care Unit, Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital, Yaoundé, Cameroon
3 Anaesthesiology and Intensive Care Unit, Sangmelima Reference Hospital, Sangmelima, Cameroon
4 Department of Emergency Medicine, Anaesthesiology and Critical Care Medicine, Laquintinie Hospital of Douala, Douala, Cameroon
5 Anaesthesiology and Intensive Care Unit, Yaoundé University Hospital Centre, Yaoundé, Cameroon
6 Department of Surgery and Sub-Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
7 Anaesthesiology and Intensive Care Unit, Douala General Hospital, Douala, Cameroon
8 Anaesthesiology and Intensive Care Unit, Yaoundé Central Hospital, Yaoundé, Cameroon
Background: There is scant data on the effectiveness and safety of adjuvant perioperative intravenous (IV) lidocaine in procuring postoperative analgesia and rehabilitation in gynecology surgery in low-resource settings.
Objectives: To evaluate the effects of IV lidocaine on postoperative pain and rehabilitation gynecology surgery.
Methods: We carried out a randomized single-blinded controlled trial from April to August 2017 (5 months) at the Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital, Cameroon. The study population was made up of ASA 1 and 2, women admitted for elective gynecological surgery under general anesthesia divided into two groups of 17 patients: those to receive IV lidocaine and those to receive normal saline as placebo both intra-and postoperatively as an adjuvant to standard care. The variables studied included the additional doses of fentanyl, postoperative pain, side effects of lidocaine, time to first bowel sounds, the ease with which patients were mobilized and patient satisfaction.
Results: Compared to patients in the placebo group, those in the lidocaine group had fewer mean amounts of fentanyl reinjections (P<0.0001), shorter recovery time (P=0.0044), reported lesser pain in the immediate postoperative period (P=0.012) till the 3rd postoperative hour (P<0.001), had more early postoperative bowel sounds (94.1% vs. 11.8%), rehabilitated earlier (P<0.001) and were more satisfied with pain management (P=0.001). The lone observed side effect of IV lidocaine was tolerable bradycardia in six (35.3%) patients.
Conclusion: Adjuvant IV lidocaine can be effectively used in gynecological surgery, with the advantage of better postoperative analgesia, quicker rehabilitation and minimal side effects.