Evaluation of postoperative recovery when combining intravenous lidocaine with ropivacaine infiltration in laparoscopic colorectal oncologic surgery: a randomized controlled trial

简要总结

主要结局

次要结局

• Assessment of plasma concentrations of lidocaine (toxic threshold >5 µg/mL) and ropivacaine (toxic threshold >2.2 µg/mL)
• Signs of local anesthetic toxicity sought in the post-anesthesia care unit (PACU) for up to two hours after the end of the procedure: o Cardiological (conduction disorders, atrioventricular conduction disorders, rhythm disorders, especially ventricular: ventricular tachycardia, ventricular fibrillation, or even cardiac arrest in asystole) o Neurological (perioral tingling, headaches, visual or auditory distortions, tremors in the extremities, loss of consciousness, coma, convulsions)
• Postoperative pain assessed using the numerical rating scale (NRS) at H2 at rest, H24 at rest and during mobilization, H48 at rest and during mobilization
• Maximum pain assessed using the NRS during the first 48 hours
• Postoperative analgesic consumption during the first 48 hours
• Consumption of morphine derivatives expressed in oral morphine equivalent (mg) per operation and 48 hours post-operatively
• Occurrence of dysesthesia (peri-scar hyperalgesia, allodynia, numbness) at the surgical site at 48 hours
• Neuropathic pain, defined as a DN4 score > 4/10 at 48 hours and 3 months
• The time before resumption of transit (resumption of gas and then bowel movements) and food tolerance will be assessed through daily interviews with the physician.
• Medical and surgical complications will be assessed using the Clavien Dindo score one month after surgery.
• Possibility of chemotherapy within two months post-op if indicated by the oncology multidisciplinary team meeting
• Length of stay from admission to discharge, expressed in days
• Patient satisfaction, assessed using the EVANS score upon discharge