Effect of Intraoperative Lidocaine vs. Dexmedetomidine Infusion on Postoperative Opioid Use in Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy is a commonly performed abdominal procedure associated with significant postoperative pain that is often treated with opioids, resulting in delayed recovery and adverse effects. The objective of this study was to compare the intraoperative intravenous lidocaine infusion versus dexmedetomidine infusion on postoperative opioid requirement in patients undergoing laparoscopic cholecystectomy under general anesthesia. Methods: A total of 300 ASA class I-II adults aged 18-60 years, scheduled for elective laparoscopic cholecystectomy were randomized into two groups: Group L (lidocaine) received a 1.5 mg/kg bolus followed by 2 mg/kg/h infusion, and Group D (dexmedetomidine) received a 1 ug/kg loading followed by 0.5 ug/kg/h infusion. Statistical analysis was performed by t-test and chi-square using SPSS v26 with a p < 0.05 for significance level. Results: Lidocaine significantly decreased 24-hour opioid consumption (12.6 ± 4.1 mg versus 15.8 ± 4.7 mg, p < 0.001). Pain scores were lower at 6 hours (3.2 ± 0.9 vs. 3.8 ± 1.0, p = 0.001) and 24 hours (2.5 ± 0.8 vs. 3.1 ± 0.9, p < 0.001). Extubation time was shorter with lidocaine (9.4 ± 2.1 vs. 11.2 ± 2.6 min, p < 0.001). The incidence of PONV, 23 (15.3%) vs. 41 (27.3%), p = 0.10, and post-anesthesia care unit (PACU) stay (42.5 ± 8.7 vs. 44.1 ± 9.2 min, p = 0.31) were not significantly different. Conclusion: Intraoperative intravenous lidocaine infusion resulted in superior opioid-sparing and analgesic effects compared to dexmedetomidine, supporting its use as a valuable adjunct.