Effectiveness of Intraperitoneal Lidocaine at 3 mg/kg Body Weight on Postoperative Pain Following Laparoscopic Cholecystectomy Under General Anesthesia

Al Ma Ariz Ridhuwan

doi:10.64531/0ttn8p96

Authors

Al Ma Ariz Ridhuwan University of Sriwijaya Author

DOI:

https://doi.org/10.64531/0ttn8p96

Keywords:

Lidocaine, 0.9% NaCl, intraperitoneal, NRS score, Laparoscopic cholecystectomy

Abstract

Background : Laparoscopic cholecystectomy often causes postoperative pain due to CO₂ insufflation. Intraperitoneal lidocaine has been proven effective in reducing pain and opioid consumption, although its dosage has not yet been adjusted based on body weight. This study aims to evaluate the effectiveness of 3 mg/kgBW intraperitoneal lidocaine compared to 0.9% NaCl in reducing postoperative pain after laparoscopic cholecystectomy.

Methods : This double-blind randomized controlled trial (RCT) was conducted on 36 patients undergoing laparoscopic cholecystectomy between March 13 and May 14, 2025. Data normality was assessed using the Shapiro-Wilk test due to the sample size being < 50. Statistical analyses included Chi-Square, paired T-test, and multivariate logistic regression to evaluate the effectiveness of lidocaine administration postoperatively.

Result : A significant difference in postoperative NRS scores was found between the lidocaine and control groups (p = 0.003), with significantly lower NRS scores in the lidocaine group. These findings align with previous studies demonstrating that intraperitoneal lidocaine significantly reduces pain scores, analgesic requirements, and postoperative nausea and vomiting. Although less effective, 0.9% NaCl also helps reduce pain by eliminating residual CO₂, which irritates the phrenic nerve. These combined factors strengthen the evidence that intraperitoneal irrigation, especially with lidocaine, is effective and safe in managing postoperative pain.

Conclusion : Administration of 3 mg/kgBW intraperitoneal lidocaine is proven to be more effective in reducing postoperative NRS pain scores in patients undergoing laparoscopic cholecystectomy compared to 0.9% NaCl.

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