Estudo randomizado, duplo encoberto do efeito da lidocaína venosa intraoperatória sobre o tempo de íleo e critérios de alta hospitalar após gastroplastia por via laparoscópica

• Ano de defesa: 2020
• Autor(a) principal: Lima, Roclides Castro De [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Lidocaine; Analgesia; Bariatric Surgery; Lidocaína; Cirurgia Bariátrica
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=9292010; https://hdl.handle.net/11600/64776

Background and Objectives: Surgical trauma, pain and opioids can cause nausea, vomiting, ileus and increased length of hospital stay. The primary objective of the present study was to evaluate the time to recovery of gastrointestinal function and the time to achieve hospital discharge criteria after laparoscopic bariatric surgery with intraoperative intravenous lidocaine administration. The secondary objective was to evaluate intraoperatory sevoflurane and postoperative morphine consumption, and the side effects of opioids. Methods: Fifty-eight patients aged 18 to 60 years who underwent bariatric surgery were allocated into two groups. Patients in group 1 were administered lidocaine (1.5 mg/kg) 5 minuts before induction of anaesthesia, and group 2 were administered 0.9% saline solution in equal volume. Subsequently, lidocaine (2 mg/kg/h) or 0.9% saline solution was infused during the entire surgical procedure. Anaesthesia was performed with fentanyl (5 μg/kg), propofol (2 mg/kg), rocuronium (0.6 mg/kg) and sevoflurane. Postoperative patient-controlled analgesia was performed with morphine. The following were evaluated: time to recovery of gastrointestinal function and time to meet discharge criteria. Results: There was no significant difference between groups regarding the time to first flatus, time to meet discharge criteria, and occurrence of side effects. The consumption of intraoperative sevoflurane and of morphine over 24 h was significantly lower in the lidocaine group. The side effects observed were nausea and vomiting, with no difference between groups. Conclusions: Intraoperative intravenous lidocaine reduces intraoperative sevoflurane and postoperative morphine consumption and is a safe for bariatric surgery.