Effect of lidocaine intravenous as part of multi modal analgesia in laparoscopic cholecystectomy

Background: Pain following laparoscopic cholecystectomy is a significant concern, often contributing to extended hospital stays or readmissions. Due to inconsistencies in analgesic protocols, a standardized approach is required to effectively manage postoperative pain. Aim of Study: To assess the efficacy of intravenous lidocaine administered at induction of anesthesia in reducing postoperative pain after elective laparoscopic cholecystectomy. Patient and Methods: A randomized clinical trial was carried out in the surgical operating unit over a one-year period from March 2019 to March 2020. The study included 150 patients scheduled for elective laparoscopic cholecystectomy under general anesthesia. Participants were randomly assigned to two groups: the lidocaine group (n = 75) received a bolus of 1.5 mg/kg IV lidocaine at induction, followed by a continuous infusion of 2 mg/kg/h until the end of surgery, along with 1000 mg paracetamol administered 30 minutes prior to surgery completion; the paracetamol group (n = 75) received only 1000 mg paracetamol at the same time point. Postoperative pain was assessed using a 10 cm visual analog scale (VAS) at the 4th and 8th postoperative hours. Results: The lidocaine group reported significantly lower VAS pain scores at both time intervals compared to the paracetamol group. Additionally, 69.3% of patients in the paracetamol group required supplemental analgesia, in contrast to only 36% in the lidocaine group—a statistically significant difference. Conclusion: Intraoperative IV lidocaine is effective in reducing postoperative pain and minimizing the need for additional analgesics following laparoscopic cholecystectomy.