Intravenous Lidocaine Infusion During Video-assisted Thoracic Procedures for Improved Pain Control

Intravenous Lidocaine Infusion During VATS Procedures Reduces Postoperative Analgesic Requirements

The purpose of this study is to determine whether intravenous lidocaine infusion during a video-assisted chest surgery is effective in reducing the pain involved after the surgery. The hypothesis is that continuous lidocaine infusion during video-assisted thoracoscopic surgery (VATS) reduces morphine consumption and postoperative pain.

Despite newer surgical techniques, many patients still experience moderate to severe postoperative pain after minimally invasive surgeries. Thoracoscopic surgeries are often associated with severe postoperative pain. To relieve the pain, potent narcotics have to be used, which have many side effects. Surgical patients would therefore benefit from an intra-operative analgesic regimen that is safe and effective, has minimal side effects and can reduce their postoperative narcotic requirements. Intravenous lidocaine has been shown previously to relieve cancer pain, chronic pain, and pain after other types of surgery.

Inclusion Criteria:

• ASA I-III
• Age 18-75
• Scheduled for VATS procedure

Exclusion Criteria:

• Patients receiving antiarrhythmic therapy (Class Ia, Ib, Ic) within one week of surgery
• Patients on preoperative analgesic therapy within one week of surgery
• Patients with history of drug or alcohol abuse
• Patients who are allergic to lidocaine
• Contraindication to self administered morphine (unable to understand the PCA)
• Progression of the procedure to thoracotomy
• Patients who need postoperative mechanical ventilation
• Necessary major deviation from the intraoperative study protocol as per the discretion of the anesthesiologist in charge of the case
• Patients who are breastfeeding or pregnant
• Patient refusal