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Thoracic epidural analgesia (TEA) is the gold standard analgesia of the laparotomy in major abdominal surgery and can be associated with intravenous lidocaine or subtituted by intravenous lidocaine when TEA is contraindicated and in order to reduce the use of the morphinics in the perioperative period.
Side effects can be paralytic ileus or nausea and vomiting and delay the enhanced recovery after surgery.
Intravenous lidocaine and TEA share several properties like anti hyperalgesia, anti inflammatory effect, intestinal process, anti tumoral effect… which suggests an additive effect of their combination that was not studied yet.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| thoracic epidural analgesia | Experimental | Lidocaine will be injected during the anaesthetic induction and infused until the surgical closure (30 minutes before the end), then ropivacaine will be injected in the TEA at the same time and infused during 24h. The occurrence of adverse events will be monitor by a physical examination and blood samples of lidocainemia and ropivacainemia in the perioperative period |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Blood sample | Other | Lidocaine blood sample 30 min before the end of the surgery Lidocaine blood sample at the end of the infusion lidocaine and ropivacaine blood sample 2 h after the ropivacaine infusion of the TEA Ropivacaine blood sample 24h after the infusion of the TEA |
| Measure | Description | Time Frame |
|---|---|---|
| Blood lidocaine concentration (micrograms/ml) | Lidocaine blood sample will be performed 30 min before the end of the surgery | 30 minutes before the end of surgery |
| blood lidocaine concentration (micrograms/ml) | lidocaine blood sample will be performed at the end of the infusion, | at the end of the surgery (assessed up to 2 hours) |
| blood lidocaine and ropivacaine concentration (micrograms/ml) | lidocaine and ropivacaine blood sample 2 h after the ropivacaine infusion of the TEA, | at 2 hours |
| blood ropivacaine concentration (micrograms/ml) | ropivacaine blood sample 24h after the infusion of the TEA | at 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Amiens | Amiens | 80480 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41790838 | Derived | Trocheris-Fumery O, Pruvot A, Tarpin P, Collette S, Bodeau S, Diouf M, Regimbeau JM, Dupont H, Bar S, Bennis Y, Abou-Arab O. A prospective observational study of plasma concentrations and safety of combined intravenous lidocaine and epidural ropivacaine in laparotomy surgery. PLoS One. 2026 Mar 6;21(3):e0344277. doi: 10.1371/journal.pone.0344277. eCollection 2026. |
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| Lidocain | Drug | Lidocaine will be injected during the anaesthetic induction and infused until the surgical closure (30 minutes before the end) The occurrence of adverse events will be monitor by a physical examination and blood samples of lidocainemia and ropivacainemia in the perioperative period. |
|
| ropivacaine | Drug | Lidocaine will be injected during the anaesthetic induction and infused until the surgical closure (30 minutes before the end), then ropivacaine will be injected in the TEA at the same time and infused during 24h. The occurrence of adverse events will be monitor by a physical examination and blood samples of lidocainemia and ropivacainemia in the perioperative period. |
|
| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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