Impact of Intraoperative Lidocaine Infusion on Recovery Profiles and Pain Scores in ERAS Protocol Patients

Abstract

Background: Optimizing postoperative recovery in abdominal surgery remains a clinical challenge, as traditional pain management often relies heavily on opioids which can delay bowel function and prolong hospital stays.

Objective: The overall objective of the research was to establish the effects of intraoperative intravenous lidocaine infusion on postoperative outcome in patients undergoing abdominal surgeries and having an Enhanced Recovery after Surgery (ERAS) regime. The second outcome involved finding its effectiveness regarding postoperative pain scale and opioid usage. Design and Setting of the study: It were a prospective randomized controlled trial and was conducted in the Department of Anesthesia, CMH/SKBZ Muzaffarabad from December 2024 to July 2025 and included 120 patients who were on abdominal surgical operations to be done under the care of ERAS.

Methodology: Pairing was done randomly to patients in the Lidocaine group (n=60), that consisted of patients who received the intraoperative intravenous lidocaine infusion of 1.5 mg/kg/h and the Control group (n=60) which involved patients who underwent standard anesthesia, but not lidocaine infusion. Standardized ERAS protocols including early mobilization and multimodal analgesia were undertaken in all the patients. Pain assessment was conducted by administering the Visual Analogue Scale (VAS) at 1, 6, 12, 24 and 48 hours narrating the operation. The parameters of recovery included time to extubation, time to Aldrete score of 9 or above, the first bowel movement, early mobilization, and length of stay.

Results: Lidocaine group scored significantly lower at all times during the post operation (p < 0.01), lesser 24-hours opioid use (18.6 +- 5.2 vs 28.9 + -7.4 mg, p < 0.001), earlier bowel movements (21.4 +- 6.3 vs 28.6 +- 7.1 hours, p < 0.001), and earlier mobility (6.8 +- 2.1 vs 9.2 There were

Conclusions: Intraoperative lidocaine infusion to enhance postoperative recovery and also reduce pain among patients undergoing ERAS is the safe and effective addition to the existing practice that involves abdominal surgery.