IV lidocaine may decrease catheter-related bladder discomfort and pain in male patients after complex spine surgery: Study
Catheter-related bladder discomfort (CRBD), a regrettable consequence post-surgery, manifests as a compelling urge to urinate, a burning sensation from the lower abdomen to the genitals, and is frequently accompanied by discomfort or a strong urge to void. Recent study aimed to investigate the effectiveness of intravenous lidocaine in preventing catheter-related bladder discomfort (CRBD) and postoperative pain in male patients undergoing complex lumbar spinal surgery. Eighty male patients scheduled for elective fusion spine surgery at least two levels were randomly assigned to receive either intravenous lidocaine or normal saline. The primary outcome was the incidence of moderate-to-severe CRBD in the post-anesthetic care unit (PACU). Secondary outcomes included postoperative pain, 24-hour postoperative opioid requirement, CRBD at various postoperative time points, patient satisfaction, and adverse effects.
Results and Conclusion
The results showed that the group receiving intravenous lidocaine had a significantly lower incidence of moderate-to-severe CRBD in the PACU and at 1 hour postoperatively compared to the control group. Additionally, the lidocaine group experienced lower average pain scores at all time points and reduced postoperative morphine requirement. Patients in the lidocaine group also reported higher satisfaction levels. No adverse outcomes were observed in either group, indicating the safety of intravenous lidocaine administration.
Implications and Limitations
The study highlighted the anti-inflammatory properties of lidocaine, which inhibit muscarinic receptors and reduce prostaglandin release, leading to a decreased incidence of CRBD and postoperative pain. The findings supported the hypothesis that intravenous lidocaine could alleviate CRBD and postoperative pain in male patients undergoing complex spine surgery. Limitations of the study included the lack of plasma lidocaine concentration assessment, the small sample size, and the absence of analysis on hospital stay length or readmission rates. Overall, intravenous lidocaine was found to be effective in reducing CRBD, postoperative pain, and opioid requirement while improving patient satisfaction in complex lumbar spinal surgery without any observed adverse effects.
Key Points
- The study aimed to investigate the effectiveness of intravenous lidocaine in preventing catheter-related bladder discomfort (CRBD) and postoperative pain in male patients undergoing complex lumbar spinal surgery.
- Eighty male patients undergoing elective fusion spine surgery were randomly assigned to receive either intravenous lidocaine or normal saline.
- Primary outcome: The group receiving intravenous lidocaine had a significantly lower incidence of moderate-to-severe CRBD in the post-anesthetic care unit (PACU) and at 1 hour postoperatively compared to the control group.
- Secondary outcomes included postoperative pain, 24-hour postoperative opioid requirement, CRBD at various postoperative time points, patient satisfaction, and adverse effects.
- Patients in the lidocaine group experienced lower average pain scores at all time points, reduced postoperative morphine requirement, and reported higher satisfaction levels.
- Study implications suggest that intravenous lidocaine's anti-inflammatory properties can inhibit muscarinic receptors and reduce prostaglandin release, leading to decreased CRBD and postoperative pain in male patients undergoing complex spine surgery. Limitations included small sample size and lack of plasma lidocaine concentration assessment.
Reference –
Chantrapannik E, Munjupong S, Limprasert N, Jinawong S. Effect of intravenous lidocaine on catheter related bladder discomfort, postoperative pain and opioid requirement in complex fusion lumbar spinal surgery: a randomized, double blind, controlled trial. BMC Anesthesiol. 2024 Nov 11;24(1):405. doi: 10.1186/s12871-024-02789-y. PMID: 39528937; PMCID: PMC11552165.
