The primary objective is to assess the feasibility and safety of administering continuous intraoperative lidocaine infusions in adult patients undergoing laparoscopic Roux en Y Gastric Bypass (RYGB). The secondary objective is to determine if lidocaine administration versus placebo (dextrose administration) (initiated at the time of anesthesia induction and continued until extubation) will reduce postoperative narcotic requirements.

Inclusion Criteria:

• Adult patients between the ages of 18-65 years old
• BMI ≥ 40 kg/m2, ≤ 60 kg/m2
• Undergoing a primary laparoscopic RYGB by Dr. Murr
• Agree to be followed 24 hours postoperatively
• Normal K+ and Mg++ serum levels

Exclusion Criteria:

• BMI less than 40 kg/m2, > 60 kg/m2
• Laparoscopic RYGB surgery performed by a surgeon other than Dr. Murr
• Allergy to lidocaine
• Allergy to hydromorphone or ketorolac
• Allergy to corn or amide anesthetics
• Use of (thioridizine)
• Pregnancy
• Abnormalities of ALT or AST
• Intra-operative diagnosis of cirrhosis or portal hypertension
• Intraoperative complications per surgeon
• Intraoperative extensive adhesions per surgeon
• Chronic pain syndrome and chronic use of narcotics
• Severe back pain secondary to degenerative joint disease

Within 1 hour post-operation

The primary outcome was the presence of lidocaine toxicity symptoms at 1 hour after lidocaine infusion cessation. We defined this endpoint as numbness or a metallic taste in the tongue or mouth, dizziness, and/or lightheadedness as reported by the patient and objectively as blood pressure changes.