IV lidocaine fails to improve gut function recovery post colonic surgery

Study design: The ALLEGRO trial, a randomized, double-blind, placebo-controlled trial conducted across 27 UK hospitals, included 557 adults undergoing elective minimally invasive colon resection. Participants were randomized to receive either 2% IV lidocaine (1.5 mg/kg bolus followed by 1.5 mg/kg/h infusion for 6 or 12 hours) or saline placebo. Primary outcome was the return of gut function at 72 hours post-surgery, defined by the GI-3 composite endpoint (tolerating diet and passage of flatus or stool).

Results: There was no significant difference in return of gut function at 72 hours between the lidocaine group (57.3%) and the placebo group (59.0%) (relative risk, 0.97; 95% CI, 0.88-1.07). Secondary outcomes, including time to GI-3 recovery, postoperative ileus, and quality of recovery, also showed no significant differences between groups.

Impact on clinical practice: Perioperative IV lidocaine doesn’t enhance gut function recovery after elective minimally invasive colon resection. Clinicians should consider other strategies for improving postoperative recovery in this patient population.

Source:

Paterson H, et al. (2024, November 27). JAMA. Intravenous Lidocaine for Gut Function Recovery in Colonic Surgery: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/39602290/