Archives of Anesthesiology and Critical Care 2017. 3(3):354-358.

The Effect of Intravenous Lidocaine Infusion on Post-Operative Pain after Percutaneous Nephro Lithotomy: A Randomized Clinical Trial
Gholamreza Movasaghi, Mahmoudreza Mohaghegh Dolatabadi, Fatemeh Sadat Mostafavi Mobasher, Valiolah Hasani, Masoud Ghorbanlo, Mehrdad Mesbah Kiaee, Zahra Sadat Koleini, Giti Fotohi


Background: Percutaneous Nephro Lithotomy (PCNL) is an efficient treatment for complicated, large and staghorn calculi. Optimal pain control has long been a concern for the surgeons and the anesthesiologist. The pivotal aim of this study is to evaluate the effects of intravenous lidocaine infusion on pain levels, sedation score, foley catheter tolerance and level of nausea and vomiting in patients undergoing the procedure.

Methods: In a randomized parallel group double blind clinical trial, 60 patients with ASA physical class I candidate for PCNL were enrolled in the study. During the operation, group A patients received 1mg/kg/hr infusion of intravenous lidocaine infusion while group B patients received normal saline infusion as placebo.

Results: Patients receiving lidocaine infusion had better foley catheter tolerance compared to the placebo group. Similarly VAS pain scores in the PACU were 2.5 ± 1.7 in group A versus 3.7 ± 1.2 in group B was observed to be higher in the placebo group leading to significant difference. (p= 0.03) One hour after surgery 4 (23%) and 26 (87%) of the patients in group A were drowsy and alert, while the results in group B were 13 (77%) and 6 (20%) respectively.

Conclusion: The results of our study demonstrates significant difference in sedation score (15 minutes and one hour after surgery) and foley catheter tolerance in patients who received lidocaine infusion through PCNL surgery. In addition, patients receiving lidocaine infusion convey better pain scores after surgery.


acute pain; lidocaine; post-operative; percutaneous nephrostomy

Full Text:



Ganpule AP, Vijayakumar M, Malpani A, Desai MR. Percutaneous nephrolithotomy (PCNL) a critical review. Int J Surg. 2016; 36(Pt D):660-4.

Sekar H, Krishnamoorthy S, Kumaresan N, Ramanan V. Supracostal Punctures for PCNL: Factors that Predict Safety, Success and Stone Free Rate in Stag Horn and Non-Stag Horn Stones: A Single Centre Experience and Review of Literature. J Clin Diagn Res. 2016; 10(9):PC17-PC21.

De Oliveira GS, Jr., Duncan K, Fitzgerald P, Nader A, Gould RW, McCarthy RJ. Systemic lidocaine to improve quality of recovery after laparoscopic bariatric surgery: a randomized double-blinded placebo-controlled trial. Obes Surg. 2014; 24(2):212-8.

McCarthy GC, Megalla SA, Habib AS. Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. Drugs. 2010; 70(9):1149-63.

van der Wal SE, van den Heuvel SA, Radema SA, van Berkum BF, Vaneker M, Steegers MA, et al. The in vitro mechanisms and in vivo efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain. Eur J Pain. 2016; 20(5):655-74.

Weibel S, Jokinen J, Pace NL, Schnabel A, Hollmann MW, Hahnenkamp K, et al. Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis. Br J Anaesth. 2016; 116(6):770-83.

Tikuisis R, Miliauskas P, Samalavicius NE, Zurauskas A, Samalavicius R, Zabulis V. Intravenous lidocaine for post-operative pain relief after hand-assisted laparoscopic colon surgery: a randomized, placebo-controlled clinical trial. Tech Coloproctol. 2014;18(4):373-80.

Kim KT, Cho DC, Sung JK, Kim YB, Kang H, Song KS, et al. Intraoperative systemic infusion of lidocaine reduces postoperative pain after lumbar surgery: a double-blinded, randomized, placebo-controlled clinical trial. Spine J. 2014; 14(8):1559-66.

Yon JH, Choi GJ, Kang H, Park JM, Yang HS. Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal gastrectomy: a prospective, randomized, double-blind, placebo-controlled study. Can J Surg. 2014; 57(3):175-82.

Kranke P, Jokinen J, Pace NL, Schnabel A, Hollmann MW, Hahnenkamp K, et al. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. Cochrane Database Syst Rev. 2015; (7):CD009642.

Dalela D, Goel A, Singh P, Shankhwar SN. Renal capsular block: a novel method for performing percutaneous nephrolithotomy under local anesthesia. J Endourol. 2004; 18(6):544-6.

Kawamata M, Takahashi T, Kozuka Y, Nawa Y, Nishikawa K, Narimatsu E, et al. Experimental incision-induced pain in human skin: effects of systemic lidocaine on flare formation and hyperalgesia. Pain. 2002; 100(1-2):77-89.

Khan JS, Yousuf M, Victor JC, Sharma A, Siddiqui N. An estimation for an appropriate end time for an intraoperative intravenous lidocaine infusion in bowel surgery: a comparative meta-analysis. J Clin Anesth. 2016; 28:95-104.

Ventham NT, Kennedy ED, Brady RR, Paterson HM, Speake D, Foo I, et al. Efficacy of Intravenous Lidocaine for Postoperative Analgesia Following Laparoscopic Surgery: A Meta-Analysis. World J Surg. 2015; 39(9):2220-34.

Ahn E, Kang H, Choi GJ, Park YH, Yang SY, Kim BG, et al. Intravenous lidocaine for effective pain relief after a laparoscopic colectomy: a prospective, randomized, double-blind, placebo-controlled study. Int Surg. 2015; 100(3):394-401.

Yang W, Hu WL. Effects of intravenously infused lidocaine on analgesia and gastrointestinal function of patients receiving laparoscopic common bile duct exploration. Pak J Med Sci. 2015; 31(5):1073-7.

Wuethrich PY, Romero J, Burkhard FC, Curatolo M. No benefit from perioperative intravenous lidocaine in laparoscopic renal surgery: a randomised, placebo-controlled study. Eur J Anaesthesiol. 2012; 29(11):537-43.

Chang YC, Liu CL, Liu TP, Yang PS, Chen MJ, Cheng SP. Effect of Perioperative Intravenous Lidocaine Infusion on Acute and Chronic Pain after Breast Surgery: A Meta-Analysis of Randomized Controlled Trials. Pain Pract. 2017; 17(3):336-343.

Vigneault L, Turgeon AF, Cote D, Lauzier F, Zarychanski R, Moore L, et al. Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials. Can J Anaesth. 2011; 58(1):22-37.

Zengin SU, Saracoglu A, Eti Z, Umuroglu T, Gogus FY. The effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement in patients undergoing laparatomy. Pain Res Manag. 2015; 20(4):179-82.

Terkawi AS, Durieux ME, Gottschalk A, Brenin D, Tiouririne M. Effect of intravenous lidocaine on postoperative recovery of patients undergoing mastectomy: a double-blind, placebo-controlled randomized trial. Reg Anesth Pain Med. 2014; 39(6):472-7.

Rajan S, Puthenveettil N, Paul J. Transtracheal lidocaine: An alternative to intraoperative propofol infusion when muscle relaxants are not used. J Anaesthesiol Clin Pharmacol. 2014; 30(2):199-202.

Tauzin-Fin P, Bernard O, Sesay M, Biais M, Richebe P, Quinart A, et al. Benefits of intravenous lidocaine on post-operative pain and acute rehabilitation after laparoscopic nephrectomy. J Anaesthesiol Clin Pharmacol. 2014; 30(3): 366–72.

Giannakopoulos S, Giannopoulos S, Gardikis S, Bantis A, Kalaitzis C, Zissimopoulos A, et al. Second-look Flexible Nephroscopy Combined With Holmium: Yttrium-Aluminum-Garnet Laser Lithotripsy Under Local Anesthesia: A Prospective Study. Urology. 2017;99:27-32.

Grady P, Clark N, Lenahan J, Oudekerk C, Hawkins R, Nezat G, et al. Effect of intraoperative intravenous lidocaine on postoperative pain and return of bowel function after laparoscopic abdominal gynecologic procedures. AANA J. 2012; 80(4):282-8.

Slovack M, Taylor B, Bryce R, Ong D. Does intravenous lidocaine infusion during video-assisted thoracoscopic surgery reduce postoperative analgesia? A randomized controlled study. Can J Anaesth. 2015; 62(6):676-7.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.