Perioperative Lidocaine Pharmacokinetics in Patients Receiving Intravenous Lidocaine Analgesia during and after Colorectal Surgery

Principal Investigator: Shireen Ahmad, MD

More than 300 patients undergo bowel surgery every year at Northwestern Memorial Hospital for a variety of digestive diseases. Understandably, a chief concern is adequate pain relief. Most patients usually receive narcotic pain medications. While good for controlling pain, they come with a host of side effects ranging from nausea and constipation to sleepiness and confusion.

Beginning in September 2016, Northwestern Memorial offered another option as part of a pilot program: intravenously-injected lidocaine. A numbing agent, it also provides pain relief but without the adverse side effects of narcotics. Additionally, lidocaine decreases inflammation and speeds recovery of bowel function after surgery. While many patients benefited from the lidocaine given at doses recommended by experts at other medical centers, a small number experienced side effects that required immediate cessation of the drug. Their metabolism of the pain reliever may have resulted in higher than expected (and higher than potentially safe) levels of lidocaine in the blood stream.

Funded by a Digestive Health Foundation grant, a research team led by Shireen Ahmad, MD, an anesthesiology faculty member at Northwestern Medicine, will study blood levels of lidocaine in 40 patients at various times while they are receiving the medication. The aim is to identify predisposing characteristics that put certain patients at risk for lidocaine-induced side effects to better individualize the dosing, safety and effectiveness of the drug. A clearer understanding of the pharmacokinetics of the drug lidocaine will help to maximize its pain-killing properties while minimizing adverse side effects of this promising alternative to narcotics for pain control.

Skills

Posted on

June 23, 2017