Key result
Combined perioperative administration of lidocaine, magnesium, and amino acids reduced postoperative inflammatory markers and pain scores compared to conventional general anesthesia.
Why the study?
Abdominal surgery triggers systemic inflammation predisposing to complications, but the effect of combining perioperative lidocaine, magnesium, and amino acids remained unstudied.
Does combined perioperative administration of lidocaine, magnesium, and amino acids reduce postoperative inflammation and pain in patients undergoing abdominal surgery?
RCT
Double-blind
Randomized
Does combined perioperative administration of lidocaine, magnesium, and amino acids reduce postoperative inflammation and pain in patients undergoing abdominal surgery?
Combined perioperative use of lidocaine, magnesium, and amino acids effectively reduces systemic inflammation and pain following abdominal surgery.
May support multimodal protocols to lower inflammation and pain after abdominal surgery; extends evidence for this combination in an RCT.
BACKGROUND Abdominal surgery is associated with a systemic inflammatory response which facilitates postoperative complications through immune imbalance and hypercatabolism. The aim of the study was to evaluate the effect of the combined perioperative lidocaine, magnesium, and amino acids on postoperative inflammation and pain. MATERIAL AND METHODS This prospective, randomized, double-blind study included 2 groups of patients undergoing abdominal surgery: Group 1 - receiving the aforementioned substances; and Group 2 - control (undergoing conventional general anesthesia). The following parameters were evaluated intraoperatively: arterial blood pressure, end-tidal CO₂ level, urine output, bispectral index, base excess, oxygen saturation, operating room temperature and body temperature (BT), opioid use, and surgery duration; and postoperatively: total leukocyte (WBC), neutrophil, lymphocyte and platelet count; fibrinogen, C-reactive protein (CRP), procalcitonin (PCT) and interleukin (IL)-6 levels; numeric rating scale (NRS) pain level, first flatus and bowel movement, and postoperative complications. The postoperative parameters were evaluated 2 h and 6 h postoperatively, as well as on postoperative days (POD) 1, 2, 3, and 5. RESULTS Group 1 showed lower counts of WBC, neutrophils, and lymphocytes and lower fibrinogen, CRP, PCT, IL-6, and BT in the first 5 POD, as well as NRS scores and time to first flatus/bowel movement. The groups did not differ significantly regarding postoperative complications. CONCLUSIONS The isolated effects of lidocaine, magnesium, and amino acids in surgery have been described previously. To the best of our knowledge, this is the first study to show the anti-inflammatory and analgesic effects of simultaneous use of these substances in abdominal surgery.
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Šarenac et al. (2023) conducted an RCT in Abdominal surgery. Perioperative lidocaine, magnesium, and amino acids vs. Conventional general anesthesia was evaluated on Postoperative inflammation and pain. Combined perioperative administration of lidocaine, magnesium, and amino acids reduced postoperative inflammatory markers and pain scores compared to conventional general anesthesia.
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