Improving Pain Control in Paraesophageal Hernia Repair: Intravenous Lidocaine Versus Placebo
Wake Forest University Health Sciences
Summary
We aim to study the impact of perioperative IV lidocaine on postoperative pain control in patients undergoing paraesophageal hernia repair. This is in the context of an established ERAS protocol. We wish to study the effect of IV Lidocaine on postoperative short and long-term outcomes, including patients' length of stay postoperative mortality, morbidity, and quality of life. We will compare this to our standard pain management.
Description
Patients will be prospectively enrolled from Carolinas Hernia Center's outpatient clinic. All paraesophageal hernia patients, age 18 and older, undergoing PEH repair at CHS will be included. We will conduct a two-arm prospective randomized study, IV Lidocaine versus placebo, to study the reduction of narcotics, return to bowel function and length of stay. Both arms will receive standard multimodal pain control in the operative and postoperative period. There will be two arms: 1. IV Lidocaine 2. Placebo. Subject participation will last approximately 6 months for this study. Lidocaine will be us…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Patients aged 18+ years of age * American Association of Anesthesiologists (ASA) scores of I-III * Undergoing elective laparoscopic paraesophageal hernia repair including robotic assisted laparoscopic cases. * All paraesophageal hernia patients seen in clinic who meet inclusion criteria will be given the option to enroll. * Cases converted to open laparotomy or hand-assisted laparoscopy will be included for intention to treat analysis. * Patients who have complications of Clavien-Dindo class 3 or greater will be included in calculations of complication rates. However, th…
Interventions
- DrugIV lidocaine
Patients randomized to the IV lidocaine group will receive a 100 mg lidocaine bolus on induction then an infusion of 1.5 mg/kg/hr prior to incision. This infusion will continue throughout operation and into the PACU for 1 hour OR until the 2gm/250 mL D5W bag has been infused, whichever occurs first.
- DrugPlacebo
o Patients randomized to the placebo group will receive D5W solution (as this is the carrier for lidocaine) at the same volume and rate as the IV lidocaine.
Location
- Atrium Health - Carolinas Medical CenterCharlotte, North Carolina