Postoperative Recovery in Patients Undergoing Laparoscopic Colorectal Surgery: Effect of Perioperative Intravenous Lidocaine

Intravenous lidocaine infusion for colorectal surgery has been shown to provide superior analgesia compared with systemic opioids and facilitate hospital discharge. While epidural analgesia has definite advantages over systemic opioids in term of return of bowel function and quality of postoperative pain control, there is no study comparing lidocaine infusion with epidural technique in the setting of enhanced recovery program (ERP) for laparoscopic colorectal surgery. In addition, functional recovery and quality of life have not been assessed and compared with other analgesic techniques. This project is designed to evaluate the impact of lidocaine on surgical and functional outcomes.;The average time to return of bowel function and median duration of hospital stay were similar in IL and TEA groups. TEA provided better postoperative analgesia than intravenous lidocaine in patients undergoing rectal surgery; otherwise there was no difference for colon resection. IL, TEA and PCA facilitated the return of postoperative functional walking capacity to baseline, and this was independent of the analgesic techniques use. However physical functioning and fatigue levels were impaired at 3 weeks after surgery with no difference between the 3 groups.;The present study demonstrated that the restoration of bowel function and diet intake were similar in both groups receiving either lidocaine infusion or epidural. Functional walking capacity at 3 weeks after surgery returned to baseline in all the groups and this was independent of the analgesic technique used. However, in all groups physical function decreased and fatigue increased and this was also independent of the type of analgesia used.;In these randomized studies, patients scheduled for elective laparoscopic colorectal surgery were prospectively randomized to receive thoracic epidural analgesia (TEA group), intravenous lidocaine infusion (IL group) or patientcontrolled analgesia with morphine (PCA group). All patients received similar surgical care in the context of ERP.