Intravenous Lidocaine Infusion in the Management of Post-operative Pain in Colorectal Patients

Intravenous Lidocaine Infusion in the Management of Post-operative Pain in Colorectal Patients

The purpose of this study is to determine if an intravenous lidocaine infusion (compared to placebo) intraoperatively will decrease time to return of bowel function postoperatively, decrease postoperative pain, diminish postoperative opioid requirement, minimize inflammatory markers and shorten time to discharge after colorectal surgery.

Lidocaine is an amide local anesthetic that has analgesic and anti-inflammatory properties. Lidocaine infusion is a very useful pain medication that is underutilized to treat surgical, chronic, and cancer pain in children. The investigators propose to examine the perioperative use of lidocaine infusion in children undergoing colorectal surgery that involves an abdominal incision. The investigators plan to measure the following outcomes: length of stay in hospital following abdominal surgery, postoperative pain scores, cumulative morphine consumption, incidences of opioid adverse-effects: respiratory depression, sedation, nausea, vomiting, time to passage of flatus, time to first bowel movement and end-tidal Sevoflurane in operating room throughout surgery. The following laboratory values will be measured: serial lidocaine levels of pharmacokinetics and safety levels, Pro- and anti-inflammatory cytokine measurements: IL-6, IL-8, IL-10, IL-1RA and genetic variants.

Inclusion Criteria:

• male or female children 1-15 years of age
• ASA physical status 1-3
• scheduled for colorectal surgery with abdominal incision
• scheduled for complex urology surgical case

Exclusion Criteria:

• ASA physical status > 3
• postoperative intubation planned ahead of surgery
• history of chronic use of opioid
• history of hepatic,renal, or cardiac failure
• history of organ transplant
• BMI > 30
• history of cardiac arrhythmia
• history of long QT syndrome
• history of allergic reaction to lidocaine or similar agents
• history of seizure disorder
• patient without Peripherally Inserted Central Catheter or other central access with contraindication to inhalation induction
• family history or know patient susceptibility to malignant hyperthermia