LIDOCAINE AND THE INHIBITION OF POSTOPERATIVE PAIN IN CORONARY-ARTERYBYPASS PATIENTS

Objective: This study was designed to evaluate whether a continuous lo w-dose lidocaine infusion reduces postoperative pain and anxiety in pa tients undergoing coronary artery bypass grafting (CABG) and to retros pectively examine time to extubation, intensive care unit stay (ICU), and hospital length of stay. Design: A double-blinded, randomized, and prospective approach. Setting: Hospital patients undergoing first-tim e CABG. Participants: After informed consent, 100 patients were enroll ed in this study. Interventions: Lidocaine infusion or placebo substit ute was begun after induction of anesthesia. The fentanyl/midazolam in fusion was discontinued on ICU admission; lidocaine or placebo continu ed until ICU discharge. Supplemental fentanyl, midazolam, or propranol ol was administered for pain, anxiety, or hemodynamic stress. Measurem ents and Main Results: Drug dosages were compared between groups. Post operative assessment included visual analog pain score, hemodynamics, sedation score, and nursing assessment. Mean total dosages of fentanyl , midazolam, and propranolol between the lidocaine and placebo groups were 620.40 +/- 815.74 mu g versus 689.16 +/- 692.99 mu g, p = 0.244; 0.54 +/- 1.13 mg versus 1.20 +/- 2.44 mg, p = 0.465; 0.11 +/- 0.75 mg versus 3.56 +/- 17.2 mg, p = 0.564, respectively. Times to extubation, ICU length of stay, and hospital stay did not achieve statistical sig nificance. Conclusions: Continuous infusion of low-dose lidocaine did not significantly decrease supplemental fentanyl, midazolam, br propra nolol requirement postoperatively. Similarly, a lidocaine infusion doe s not result in reduced time to extubation, ICU stay, or hospital leng th of stay. (C) 1995 by W.B. Saunders Company