Perioperative infusion of lidocaine vs dexmedetomidine - anaesthetic sparing effect in laparoscopic surgery

Lidocaine is an amide local anesthetic has analgesic, antihyperalgesic, and anti- inflammatory effects due to sodium channel blockade and inhibition of N-methyl- D-aspartate (NMDA) receptors [1]. Intravenous lidocaine provides pain relief after open abdominal surgery and laparoscopic surgery.

[2]

Use of perioperative lidocaine infusion include reductions in pain, nausea, ileus duration, opioid requirement, and length of hospital stay [3-8]. Lidocaine has a stabilizing effect on the heart and blood pressure, possibly by direct myocardial depressant effect, a peripheral vasodilating effect, and through its anti- inflammatory activity.

[9]

Dexmedetomidate, an imidazole compound is a pharmacologically active dextroisomer of medetomidine that displays specific and selective α2-adrenoceptor agonism. Activation of these receptors in the brain and spinal cord inhibits neuronal firing, causing hypotension, bradycardia, sedation, and analgesia. Dexmedetomidine is a specific alpha 2adrenergic receptor agonist that has anti- nociceptive and sedative properties.

Intravenous dexmedetomidine has a role as postoperative analgesia, which leads to the reduced requirement for opioids

[10-13] The goal of the current study is to compare the effects

Perioperative lidocaine infusion is commonly used as analgesic adjunct in

enhanced recovery protocols for patients undergoing laparoscopic

surgeries to control the intraoperative and postoperative pain scores,

decrease opioid consumption, and shorten length of hospital stay and

increase patients comfort (Terkawi et al. 2016).

Dexmedetomidine was a selective alpha 2 agonist as clonidine, but it has a greater

affinity to the alpha 2 receptor with hypnotic properties similar to natural sleep and

effectively attenuates the stress response to the surgical intervention with minimal

or no respiratory depression complication. Also, maintained hemodynamic stability

through its function on the central and peripheral alpha 2 receptors leads to

reduction of heart rate and the systemic vascular resistance (Bos et al. 2017).

of perioperative intravenous lidocaine and dexmedetomidine

on the anesthetic consumption, anesthesia induction, recovery

times, and the time to the first postoperative analgesic

requirement in patients who undergo elective laproscopic

surgeries under general anesthesia.