Small doses of lidocaine delivered intravenously during common outpatient procedures is a safe and inexpensive way to control post-op discomfort, which authors of a new study cite as the most common reason for delay in discharge and unplanned hospital admission after ambulatory surgery.

Researchers led by Danja S. Groves, MD, PhD, from the department of anesthesiology at the University of Virginia in Charlottesville observed 67 patients undergoing general laparoscopic and open procedures, endocrine and breast procedures, laparoscopic gynecologic surgery, urologic procedures, plastic surgery, and minor orthopedic and ENT surgery. Patients received either a lidocaine or saline placebo infusion, which began at anesthesia induction and continued until 1 hour after arrival in recovery.

Patients who received lidocaine reported lower average post-op pain scores compared to patients in the placebo group (3 vs. 4.5, respectively, on a scale of 0 to 10), according to results published in the December issue of the journal Anesthesia & Analgesia. Additionally, opioid use to control post-op pain was reduced by approximately 40% in the lidocaine cohort. There was no significant difference in length of stay before discharge between the lidocaine and saline groups.

Christopher L. Wu, MD, an associate professor in the department of anesthesiology and critical care medicine at Johns Hopkins University in Baltimore, Md., and Spencer S. Liu, MD, from the department of anesthesiology at the Hospital for Special Surgery in New York, N.Y., are encouraged with the study's results, but point out that opioid-related side effects persisted, post-op pain scores were reduced only for a few hours and length of stay in PACU was not affected. "Future studies examining interventions in ambulatory anesthesia should consider assessing both patient-reported outcomes and post-discharge symptoms," write the doctors.

Daniel Cook