Bowel Function After Laparoscopic Colon Surgery: Effect of IV Lidocaine

Study Overview
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Brief Summary
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Patients receiving perioperative intravenous lidocaine, post operative restoration of bowel movement will be faster and decrease pain intensity, opioid consumption and side effects, length of hospital stay; probably as a result of a significant opioid sparing and attenuated inflammatory response.

Detailed Description
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The aim of this study is to assess whether perioperative intravenous lidocaine has an impact on the early postoperative physical activity recovery of patients scheduled for laparoscopic colorectal resection. The study focuses on patients with colorectal disease, which receive the laparoscopic (assisted) surgical approach. It is hypothesized that in those patients receiving perioperative and post-operative intravenous lidocaine, bowel function recovery will be faster, probably as a result of a significant opioid sparing, less pain and attenuated inflammatory response.

Official Title
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Restoration of Bowel Function After Laparoscopic Colorectal Surgery: Effect of Intravenous Lidocaine

Conditions
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Colon Cancer, Inflammatory Bowel Diseases, Diverticulitis

Intervention / Treatment
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* Drug: Lidocaine
* Procedure: Thoracic epidural block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: scheduled to undergo laparoscopic colorectal resection Exclusion Criteria: patients who have trouble to understand, read or communicate either in French or in English dementia patients suffering from severe physical disability (arthritis, neuromuscular dysfunction, stroke, paraplegia) or inability to walk or conduct daily activity patients suffering from severe cardiac or respiratory disease (status ASA IV patients suffering from metastatic carcinoma patients who have a history of chemoradiation within the six months preceding surgery allergy to lidocaine morbid obesity patients with chronic opioid use.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LIDOCAINE group<br>Beside general anesthesia, patients will receive intravenous lidocaine bolus 1.5 mg/kg just prior induction and an infusion of lidocaine 2mg/kg/h will be started and maintained during the whole surgical procedure. Entering the recovery room, this infusion will be decreased at the rate of 1mg/kg/hour for the 48 first hours | Drug: Lidocaine<br>* 1% Lidocaine 1mg/kg/hr IV drip x 48hr<br>* Other names: Xylocaine;|
| Active Comparator: Epidural group<br>Beside general anesthesia, patient will receive epidural freezing medication for 48 hours. | Procedure: Thoracic epidural block<br>* 0.1% Epidural bupivacaine + Morphine 0.02 mg/ml drip via epidural x48 hr<br>* Other names: Thoracic Epidural analgesia;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Restoration of bowel function |  | 72 hours after an operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity | Visual analog score pain (from 0-10) at rest, on walking and coughing at 24, 48 and 72 hours after an operation are assessed. | within 72 hours after an operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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60 patients scheduled to have a colorectal surgery, recruit at Montreal General Hospital