OBJECTIVE

To compare adjuvant use of lidocaine and standard anesthesia mode based on fentanyl and paracetamol after cardiac surgery.

MATERIAL AND METHODS

There were 90 patients after elective cardiac surgery. Pain intensity was assessed immediately after weaning from ventilator, 2, 6, 12, 18 and 24 hours later. Patients were randomized into 3 groups: continuous intravenous administration of lidocaine 0.5 mg×kg–1×h–1 on the background of standard analgesia with intravenous administration of fentanyl 0.5 μg×kg–1×h–1 and paracetamol 1 g every 8 hours (the 1^st group, n=30); intrapleural administration of lidocaine 200 mg every 6 hours on the background of standard analgesia (the 2^nd group, n=30); standard analgesia alone (the 3^rd (control) group, n=30).

RESULTS

VAS scores were similar in all groups throughout the follow-up period (p>0.05). VAS scores were 4-5 points immediately after weaning from ventilator and 2 hours later, 3-4 points after 6 and 12 hours, 2-2.5 points after 18 and 24 hours. In 25% of patients in the second group, arterial hypotension required discontinuation of lidocaine administration, while the incidence of postoperative nausea and vomiting was lower compared to the control group (p=0.007). Moreover, there was a tendency to decrease in the incidence of sedation compared to other groups (p=0.094). Duration of mechanical ventilation, need for vasopressors and ICU-stay were similar in all groups.

CONCLUSION

Continuous intravenous infusion of lidocaine 0.5 mg×kg–1×h–1 in postoperative period does not have additional analgesic and opioid-saving effects in patients after elective cardiac surgery. Moreover, infusion does not affect blood pressure, duration of postoperative mechanical ventilation and ICU-stay. Intrapleural administration of lidocaine 200 mg every 6 hours reduced the overall incidence of opioid-related complications, but discontinuation of treatment was often required.