INTRAVENOUS LIDOCAINE SPEEDS THE RETURN OF BOWEL FUNCTION, DECREASES POSTOPERATIVE PAIN, AND SHORTENS HOSPITAL STAY IN PATIENTS UNDERGOING RADICAL RETROPUBIC PROSTATECTOMY

Postoperative ileus is a concern among surgical patients. Epidural ane sthesia and analgesia with local anesthetics can decrease the duration of ileus. Significant systemic absorption of local anesthesia occurs during epidural use. In this study, we examined whether many of the be neficial effects on bowel function seen with epidural lidocaine are al so present when the drug is given parenterally. Forty patients undergo ing radical retropubic prostatectomy were studied with one half of the patients receiving a lidocaine bolus (1.5 mg/kg) and infusion (3 mg/m in, unless weight <70 kg, then 2 mg/min); the other half received a sa line infusion. A blind observer recorded the patient's daily pain scor e, the time the patient first experienced flatulence and had the first bowel movement, and the total use of analgesics. Lidocaine-treated pa tients first experienced flatulence in a significantly shorter time (P < 0.01) than control patients. Lidocaine patients' hospital stay was also significantly shorter (P < 0.05); on average, they spent 1.1 fewe r days in the hospital. TV lidocaine initiated before anesthesia and c ontinued 1 h postoperatively significantly sped up the return of bowel function. Lidocaine patients were also more comfortable postoperative ly. Many of the bowel function benefits attributed to epidural lidocai ne are also present when the drug is administered parenterally. Additi onally, the length of hospital stay was reduced in lidocaine-treated p atients. Implications: This study prospectively examined whether TV li docaine could affect the return of bowel function after radical prosta te surgery. Lidocaine-treated patients had shorter hospital stays, les s pain, and faster return of bowel function. In this population, lidoc aine infusion can be a useful adjunct in anesthetic management.