Effect of intravenous lignocaine on perioperative stress response and post-surgical ileus in elective open abdominal surgeries: a double-blind randomized controlled trial

Background Perioperative stress response can be detrimental if excessive and prolonged. Intravenous (i.v.) lignocaine, while being an effective analgesic, has the added benefit of anti‐inflammatory activity. This study was done to assess the effect of i.v. lignocaine on operative stress response and post‐surgical ileus after elective open abdominal surgeries. Methods Patients (n = 134) were randomized into two groups (n = 67 each) to receive an i.v. infusion of lignocaine (group L) or saline (group S) as a bolus of 1.5 mg/kg at intubation followed by an infusion of 1.5 mg/kg/h throughout the surgery until 1 h post‐surgery. Total leukocyte count (TLC), C‐reactive protein (CRP) and interleukin‐6 (IL‐6) levels immediately and 24 h after surgery were compared with preoperative levels. Time to first passage of flatus and stools post‐operatively was noted. Post‐operative pain scores, analgesic requirements, and incidence of post‐operative nausea and vomiting (PONV) were assessed in the two groups. Results Post‐operative surge in TLC, CRP and IL‐6 was attenuated in group L as compared to group S (P < 0.001, 0.018,