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The goal of this clinical trial is to learn about effect of intraoperative continuous lidocaine infusion on postoperative pain, gut function and insulin resistance in patients undergoing laparoscopic liver surgery in adults. It will also learn about the safety of this infusion in this setting. The main questions it aims to answer are: does the intraoperative continuous systemic lidocaine infusion lower the opioid consumption 24h after surgery? Is the time to first flatus after surgery reduced? Is there increases in insulin resistance after intraoperative lidocaine infusion? Researchers will compare intraoperative continuous systemic lidocaine infusion to a placebo (a look-alike substance that contains no drug, which will be normal saline administered at the same volume, infusion rate and timing) to see if intraoperative continuous systemic lidocaine infusion reduces postoperative pain after laparoscopic liver resection.
Participants will receive intraoperative continuous systemic lidocaine infusion or placebo. Clinical assessment will be based on gathering data of NRS scores after the surgery, time to first flatus or stool. How much opioids the patients need in the first 3 postoperative days. Laboratory assessment will include the evaluation of fasting blood glucose concentration and insulin levels preoperatively and on 1, 2 and 3 postoperative days.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| The lidocaine group | Experimental |
| |
| The placebo group | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| lidocaine infusion | Drug | The lidocaine group will receive initial intravenous bolus dose of 1.5mg/kg lidocaine over 10 min, followed by a continuous infusion of 1.5 mg/kg/h lidocaine until the end of surgery. The dose of lidocaine will be calculated according to ideal body weight. The placebo group will be administered normal saline at the same volume, infusion rate and timing. |
| Measure | Description | Time Frame |
|---|---|---|
| opioid consumption during the first 24 hours after the surgery | the mean cumulative opioid consumption during the first 24 hours after the surgery | First 24 hours after the end of the surgery (extubation) |
| Measure | Description | Time Frame |
|---|---|---|
| gut recovery | time to first flatus or stool after surgery | from the end of the surgery (extubation) until the date of first documented flatus or stool, whichever came first, assessed up to 72 hours |
| HOMA-IR |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Paula Dudek, MD | Contact | +48225992002 | paula.dudek@wum.edu.pl |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| Placebo | Other | The placebo group will be administered normal saline 0.9% at the same volume, infusion rate and timing as lidocaine in the lidocaine group |
|
fasting blood glucose concentration, insulin levels preoperatively
| from the day 0 after surgery to day 3 after surgery |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |