Intravenous lidocaine and postoperative bowel motility in laparotomies for generalized acute peritonitis: double-blind randomized clinical trial at souro-sanou teaching hospital in Bobo-Dioulasso, Burkina Faso

Introduction:The reduction of the duration of postoperative paralytic ileus remains a major challenge for anesthetists in digestive surgery.Different strategies have been proposed including the use of intravenous lidocaine perioperatively.The objective of this study was to evaluate the effect of intravenous lidocaine on postoperative bowel motility in urgent abdominal surgery.Method: This was a randomized, double-blind, 6-month clinical trial at Souro-Sanou teaching hospital in Bobo Dioulasso, Burkina Faso.The patients included in the study were separated after randomization into 2 groups, one receiving lidocaine intravenously perioperatively and the other receiving saline (placebo).The main evaluation criteria were the intestinal transit recovery time and the length of the hospital stay.Secondary endpoints included pain control, opioid need, and mortality.Results: Out of 194 patients who had laparotomy for generalized acute peritonitis during the study period, 65 patients were analyzed, including 31 in the placebo group and 34 in the lidocaine group.The average age in patients was 39.4 years.The average time taken to treat patients in our study was 17h±2.7;with extremes of 1 h and 144 h.The average consumption of sufentanil was 20.6µg and 24.1µg respectively in the lidocaine group and the placebo group, a reduction of 14.5% in the intraoperative consumption of opioids (p=0.03).At the 48th postoperative h, no patients in the placebo group had stooled against two patients in the lidocaine group (p=0.07).The average hospital stay was 6.4 days (p=0.8) in both groups.The overall mortality was 10.8%.Conclusion: Perioperative intravenous lidocaine does not reduce the duration of postoperative paralytic ileus, but has a significant analgesic effect thus allowing significant morphine savings.