Effect of Perioperative Intravenous Lidocaine Infusion in Robotic-Assisted Urologic Surgery
Condition: Kidney Cancer; Prostate Cancer
MeSH terms: Kidney Neoplasms
Intervention: Lidocaine Hydrochloride 0.8% in Dextrose 5% Solution; 0.9% Sodium Chloride Injection
Intervention description: Lidocaine Hydrochloride and 5% Dextrose Injection, USP is a sterile, nonpyrogenic solution prepared from lidocaine hydrochloride and dextrose in water for injection.; Sodium Chloride Injection USP is sterile, nonpyrogenic, isotonic and contains no bacteriostatic or antimicrobial agents.
Intervention MeSH terms: Lidocaine
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants will receive either intraoperative 0.8% lidocaine or normal saline at 1 mg/kg/h when younger than 65 years and 0.5 mg/kg/h when greater than or equal to the age of 65 to be delivered by continuous infusion for 24 hours.
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking description: The surgeon, anesthesiologist, operating room staff, participant, personnel in the postanesthesia care unit (PACU) as well as the investigators collecting the postoperative data will be blinded to the group allocation. Study medication is prepared and masked by an unblinded investigation drug pharmacist who is not involved in clinical care.
Enrollment: 21.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: prostatectomy; partial nephrectomy; robotic surgery; intravenous lidocaine; lidocaine hydrochloride

Summary:

      Controlling pain is fundamental during and after surgical procedures. This study examines
      pain associated with robotic assisted surgery on prostate cancer or a kidney mass. In recent
      years, the risk of opioids in the postoperative period has gained interest due to the growing
      epidemic of addiction, dependence, and overdose. In this study, the investigators expect a
      continuous infusion of intravenous lidocaine during the perioperative period to result in
      less pain and less opioid use.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Undergoing robotic assisted prostatectomy or robotic assisted partial nephrectomy at
             University of Missouri Hospital for prostate cancer or kidney mass

          -  Age ≥ 18 years

          -  ASA I-III

        Exclusion Criteria:

          -  Inability to obtain written informed consent

          -  Allergy to lidocaine or other amide local anesthetics

          -  Atrioventricular conduction blocks

          -  CV instability and concomitant use of alpha agonists or beta blockers

          -  Recent myocardial infarction (≤ 6 months ago)

          -  Cardiac arrhythmia disorders

          -  Stokes-Adams syndrome

          -  Wolff-Parkinson-White syndrome

          -  Seizure disorders

          -  Liver failure or hepatic dysfunction

          -  Significant renal disease with a serum creatinine ≥ 2 mg/dl

          -  A family history of malignant hyperthermia

          -  Current use of opioids or documented history of opioid abuse

          -  Typically, have less than 3 bowel movement per week

          -  Combined surgical cases that include robotic prostatectomy or robotic partial
             nephrectomy