None listed
Conditions
Brief summary
Intravenous lidocaine infusions have demonstrated benefits for improving analgesia and recovery after laparoscopic abdominal surgery. However, there are inconsistencies regarding the dosing of lidocaine infusions with concerns for safety and efficacy, particularly when using a weight-based protocol in patients with obesity. It is likely that current dosing regimen result in sub-therapeutic levels in patients. This study aims to prospectively evaluate a proposed optimised regimen to determine if it achieves targeted concentrations. We will also assess the feasibility of administering a standardised anaesthesia protocol and collecting a range of patient-focused outcomes.
Interventions
An intravenous lidocaine infusion regimen will be administered in patients with BMI >30kg/m2 having elective laparoscopic abdominal surgery. A regimen dosed according to lean body weight of of 2mg/kg bolus over 20 minutes commencing prior to skin incision, followed by 3mg/kg/hour for 80 mins then reduced to 2mg/kg/hour until completion of the surgery will be delivered and documented by the treating anaesthetist.
Intravenous lignocaine infusions are widely regarded as a valuable adjunct to lapa
An intravenous lidocaine infusion regimen will be administered in patients with BMI >30kg/m2 having elective laparoscopic abdominal surgery. A regimen dosed according to lean body weight of of 2mg/kg bolus over 20 minutes commencing prior to skin incision, followed by 3mg/kg/hour for 80 mins then reduced to 2mg/kg/hour until completion of the surgery will be delivered and documented by the treating anaesthetist. 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
Department of Anaesthesia Royal Brisbane and Women's Hospital
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
BMI greater than or equal to 30 kg/m2 Elective laparoscopic abdominal surgery, expected > 90 mins duration, positioned with one arm available for venous sampling Informed consent
Exclusion criteria
Known or suspected allergy or contraindication to lidocaine or other amide local anaesthetics, including patients with porphyria and methaemaglobinaemia Acute or chronic renal disease (estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2) Acute or chronic liver disease (based on laboratory reference range values) Congestive cardiac failure or cardiac conduction abnormalities (e.g. heart block, bundle branch block, prolonged QT interval, Wolf Parkinson White Syndrome, or channelopathy (e.g. Brugada Syndrome) Pregnancy History of seizure disorder
Outcome results
None listed