Association of Intraoperative Low-Dose Lidocaine Infusion with Postoperative Tramadol Requirement After Laparoscopic Cholecystectomy: A Retrospective Analysis

ABSTRACTAim: Intravenous lidocaine infusion has been proposed as an opioid-sparing adjunct in multimodal analgesia; however, its efficacy following laparoscopic cholecystectomy remains controversial. This study evaluated the association between intraoperative low-dose lidocaine infusion, postoperative tramadol consumption, and hospital length of stay.Methods: Ninety-four patients undergoing elective laparoscopic cholecystectomy were retrospectively analyzed. Patients received either intraoperative lidocaine infusion (1.5 mg/kg bolus plus 1 mg/kg/h infusion, n=47) or standard multimodal analgesia alone (n=47). Postoperative tramadol requirement, total tramadol consumption, surgical duration, and hospital length of stay were compared between groups.Results: Baseline characteristics were similar between groups. The number of patients requiring postoperative tramadol was lower in the lidocaine group than in the control group (8.5% vs. 19.1%); however, this difference did not reach statistical significance (p=0.231). Total postoperative tramadol consumption was also lower in the lidocaine group, although no significant difference was observed (p=0.167). No significant differences were observed in surgical duration (p=0.064) or hospital length of stay (p=0.663).Conclusions: Intraoperative low-dose intravenous lidocaine infusion was associated with a clinically meaningful reduction in postoperative opioid requirement following laparoscopic cholecystectomy, although statistical significance was not achieved. These findings suggest that lidocaine may serve as a valuable adjunct within multimodal analgesia protocols. Larger prospective randomized controlled studies are warranted to further clarify its clinical benefits.Keywords: Lidocaine; Laparoscopic Cholecystectomy; Postoperative Pain; Opioid; Enhanced Recovery After Surgery.