Impact of Intra- and Postoperative Continuous Infusion of Lidocaine on Analgesia in Vascular Anaesthesia
Status:
Suspended
Trial end date:
2022-02-01
Target enrollment:
Participant gender:
Summary
The aim of the study is to test the effectiveness and safety of the use of lidocaine infusion
in multimodal analgesic management. A group of patients undergoing vascular surgery performed
with the classic technique on the aorta - with the opening of the abdominal cavity will be
enrolled. The population of patients qualified for this type of vascular surgery is usually
burdened with multiple diseases, mainly risk factors or cardiovascular diseases, which,
combined with hemodynamic fluctuations, large fluid shifts (including bleeding) and stress
for the body, affects the risk of serious cardiological complications, which in this group
exceeds 5% and is the highest, according to the ESC / ESA (European Society of Cardiology /
European Society of Anesthesiology) classification from 2014. Proper postoperative pain
control is therefore becoming one of the key pillars of postoperative care in this group of
patients.
Due to the numerous disease burden of patients and the operational specifics, the use of
multimodal therapy in the management of pain is of particular importance, as the use of high
doses of opioids improves hemodynamic stability, but at the same time affects the occurrence
of side effects - mainly excessive sedation, respiratory disorders, hypoventilation and,
consequently, for hypoxia of the heart muscle. The risk of myocardial injury in non-cardiac
surgery (MINS) is significant in the light of the available literature.
Lidocaine used in intravenous infusion is one of the recommended components of
multidirectional analgesia. Its adjuvant properties make it possible to reduce the amount of
opioid drugs used, and thus - to reduce the frequency of their side effects. The high
effectiveness of such a procedure has been proven in numerous experimental and
epidemiological studies. Due to the low frequency of side effects associated with its use,
the therapy has a strong recommendation for use in relieving perioperative pain. The analysis
of the literature on the subject shows that there is little data assessing effectiveness of
lidocaine infusion in relation to the group of patients after surgery on the abdominal aorta.