None listed
Conditions
Brief summary
Perioperative lignocaine infusions have significant benefits for patients undergoing major abdominal surgery in regards to analgesia, reduced opioid requirements, earlier return of normal bowel function and potentially even enhanced recovery and discharge after surgery. Currently there is significant heterogeneity in the various suggested lignocaine dosing regimens and a real paucity of evidence in regards to optimal dosing in the bariatric population. As a result, despite the benefits of perioperative lignocaine infusions particularly in the bariatric population, clinicians cannot be confident about the efficacy and safety of currently suggested lignocaine infusion regimes in this population group. As a result our objective is to develop a pharmacokinetic model of lignocaine infusion including patients at the extremes of BMI and thus develop a regimen for bariatric patients that achieves safe but effective therapeutic dosing.
Interventions
Intravenous lignocaine infusion of 1.5mg/kg bolus over 10 minutes on induction of anaesthesia followed by 1.5mg/kg/hour throughout the duration of patient's laparoscopic abdominal procedure which will vary depending on each individual patient's specific surgical requirements.
Intravenous lignocaine infusions are widely regarded as a valuable adjunct to laparoscopic abdominal surgical procedures however their use in this population group, with the current level of evidence, is entirely dependan
Intravenous lignocaine infusion of 1.5mg/kg bolus over 10 minutes on induction of anaesthesia followed by 1.5mg/kg/hour throughout the duration of patient's laparoscopic abdominal procedure which will vary depending on each individual patient's specific surgical requirements. Intravenous lignocaine infusions are widely regarded as a valuable adjunct to laparoscopic abdominal surgical procedures however their use in this population group, with the current level of evidence, is entirely dependant on anaesthetist preference. As such in some cases intravenous lignocaine infusions would be used regardless but in some cases they will be utilised specifically for the purposes of the study
Sponsors
RBWH Anaesthetic Department
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
Patients scheduled for elective laparoscopic abdominal surgery Surgical duration expected to be of at least 90 minutes duration Patients of a range of BMIs according to the WHO definitions - 10 patients with a BMI of < 35kg/m2, 10 patients with a BMI of 35-40kg/m2 and 10 patients with a BMI > 40kg/m2 Informed consent by patient or legally authorised representative to participate in study and to store specimens for immediate and future analysis.
Exclusion criteria
Known or suspected allergy to study drug (lignocaine) Acute or chronic renal disease (eGFR < 60) Acute or chronic liver disease Congestive cardiac failure Cardiac conduction abnormalities Pregnancy History of seizure disorder Known vascular disease of the upper limb (e.g. Raynauds disease), or other contraindication to arterial catheterisation
Outcome results
None listed