Evaluation of lignocaine infusion on recovery profile, quality of recovery, and postoperative analgesia in patients undergoing total abdominal hysterectomy

Background and Aims: Multimodal analgesia entrains the use of drugs in perioperative period producing adequate pain relief without affecting the quality of recovery by decreasing drug-related adverse effects. Systemic lignocaine has effective analgesic, anti-inflammatory, and anti-hyperalgesic properties and improves the quality of recovery after surgery. Material and Methods: Ninety women scheduled for elective transabdominal hysterectomy under general anesthesia were randomized to receive infusion of lignocaine (1.5 mg/kg over 15 min followed by a 2 mg/kg/h infusion until the end of surgery) (Group 1) or normal saline (10 mL over 15 min followed by infusion 1 mL/kg/h till end of surgery) (Group 2). Standard anesthesia techniques were used in both the groups. The patients received inj. tramadol for postoperative analgesia. Perioperative hemodynamics, extubation variables, postoperative analgesic requirement, and quality of recovery score were evaluated. Results: Hemodynamics were maintained in both the groups. Time for extubation was also similar. Demand for first postoperative analgesic was after 70.8 +/- 70.4 min (Group 1) and 40.7 +/- 30.0 min (Group 2) (P = 0.006). Total tramadol usage was 477.0 +/- 133.2 mg (Group 1) and 560.0 +/- 115.0 mg (Group 2) (P < 0.001). Return of bowel function was faster in Group 2 compared with Group 1 (37.1 +/- 5 vs 41.8 +/- 7.4 h, P < 0.001). The median (interquartile range) recovery score (QoR-40) was 184 (178-191) in Group 1 and 178 (171-180) in Group 2 (P < 0.001). Conclusion: Perioperative use of intravenous infusion of lignocaine is associated with decreased analgesic requirement postoperatively, and improved quality of recovery score signifying greater patient satisfaction.