Thoracic epidural analgesia (TEA) is the gold standard analgesia of the laparotomy in major abdominal surgery and can be associated with intravenous lidocaine or subtituted by intravenous lidocaine when TEA is contraindicated and in order to reduce the use of the morphinics in the perioperative period. Side effects can be paralytic ileus or nausea and vomiting and delay the enhanced recovery after surgery. Intravenous lidocaine and TEA share several properties like anti hyperalgesia, anti inflammatory effect, intestinal process, anti tumoral effect… which suggests an additive effect of their combination that was not studied yet.
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Blood lidocaine concentration (micrograms/ml)
Timeframe: 30 minutes before the end of surgery
blood lidocaine concentration (micrograms/ml)
Timeframe: at the end of the surgery (assessed up to 2 hours)
blood lidocaine and ropivacaine concentration (micrograms/ml)
Timeframe: at 2 hours
blood ropivacaine concentration (micrograms/ml)
Timeframe: at 24 hours