Effects of lidocaine versus fentanyl infusions on hemodynamics and postoperative pain in patients undergoing laparoscopic cholecystectomy: a prospective randomized double-blind controlled study

Background Laparoscopic cholecystectomy (LC) may cause hemodynamic changes and postoperative pain from CO 2 pneumoperitoneum. Fentanyl is used to counteract these effects, with side effects. Lidocaine may offer a safer alternative. Aim To contrast the efficacy of intraoperative lidocaine and fentanyl infusions on hemodynamic reaction to pneumoperitoneum and postoperative pain in individuals scheduled for LC. Patients and methods This prospective randomized double-blind controlled study was carried out on 60 participants, placed into two equal groups. Lidocaine group: loading dose of intravenous (i.v.) 1.5 mg/kg lidocaine hydrochloride over 2 min before skin incision, followed by i.v. infusion of 2 mg/kg/h lidocaine hydrochloride. Fentanyl group: loading dose of i.v. 0.5 μg/kg fentanyl over 2 min before incision, followed by i.v. infusion of 0.5 μg/kg/h fentanyl. Results Heart rate showed no significant difference at T0–T2 and was significantly reduced at T3–T9 and T end in group L than group F ( P <0.05). Mean arterial pressure was insignificantly different at T0–T1 and significantly reduced at T2–T9 and T end in group L than group F ( P <0.05). Visual analog scale was significantly reduced at 2, 4, 12, and 16 h, and significantly elevated at 8 h in group L than group F ( P <0.05). Conclusion Lidocaine infusion is more effective than fentanyl in stabilizing hemodynamics and reducing postoperative pain and opioid use, without significant difference in postoperative nausea and vomiting or headache in LC patients.