Effect of Lignocaine on Postoperative Serum Lactate Dehydrogenase and Lactate Levels in Patients Undergoing Bowel Surgery

Abstract

Objective: To evaluate effect of intraoperative lignocaine on postoperative serum LDH and lactate levels and to compare with placebo in patients undergoing bowel surgery.

Methodology: This randomized controlled trial was conducted at the Department of Biochemistry, Islam Medical, Sialkot, Pakistan from August 2023 to January 2024. Serum LDH and lactate levels were measured preoperatively on automatic biochemical analyzer (produced by Beckman Coulter, GRM, 2166) was used to analyze, before extubation, and at 6 and 24 hours postoperatively, between patients who received intraoperative lignocaine versus those who received saline during bowel surgery under general anesthesia.

Results: The study involved two groups: Group lignocaine (n = 20) where patients received 2% lignocaine at the rate of 1.5 mg/kg intravenous followed by maintenance infusion at the same rate until the end of surgery, and Group normal saline (n = 20) where patients received normal saline at the rate 1.5 mg/kg IV followed by infusion at the same rate until the end of surgery The average serum lactate postoperative, before extubation, 6 hours and 24 hours of lignocaine group was 2.68±0.32 mmol/l, 1.26±0.22 mmol/l, 1.09±0.28 mmol/l, and 1.15±0.13 mmol/l, respectively (p<0.001). Whereas the average serum lactates at postoperative, before extubation, 6 hours and 24 hours of normal saline group was 2.86±0.37 mmol/l, 2.64±0.65 mmol/l, 2.15±0.31 mmol/l, and 1.65±0.38 mmol/l, respectively (p<0.001).

Conclusion: Patients undergoing bowel surgery who received intraoperative IV lignocaine exhibited lower postoperative serum LDH and lactate levels compared to those who received normal saline. It was also concluded that indirectly intravenous lignocaine also improves postoperative outcomes by reducing pain and hospital stay.