Evaluation of effects of intravenous lignocaine infusion on postoperative analgesia after upper abdominal surgery.

The pain anddiscomfort after major surgical procedures are well known. Despite advances inknowledge of pathophysiology, pharmacology of analgesics and the development ofmore effective techniques for post-operative pain control, many patientscontinue to experience appreciable discomfort. Patients undergoing majorabdominal operations experience severe pain and marked respiratory impairmentbecause of pain in the postoperative period.4

We areincreasingly becoming aware of the risks associated with the use of invasivetechniques in the treatment of postoperative pain. Epidural infusions arecertainly more expensive, cumbersome and invasive than intravenous infusions.Furthermore, modern thromboprophylaxis practice with low molecular weightheparins often preclude the use of continuous epidural therapy because ofconcern over risk of epidural bleeding and hematoma. It is becomingincreasingly apparent that local anaesthetic such as lignocaine in the systemiccirculation can profoundly alter post-operative pain.  Intravenous lignocaine in the therapeuticdose as used for cardiac arrhythmias treatment, have been shown to reducepostoperative pain scores and opioid consumption; the presence of these drugsin the circulation for only a few hours can suppress pain for days after surgery.Therefore, intravenous lignocaine is appealing as a simple and inexpensivemethod to gain the same benefits as more invasive and costly techniques.