The efficiency of intravenous lidocaine infusion in postoperative pain relief in patients undergoing hysteroscopy

Introduction: Hysteroscopy is a frequently used method in the diagnosis and treatment of pathologies such as abnormal uterine bleeding, infertility, endometrial disorders, uterine fibroids, and intrauterine synechiae. Hysteroscopy can be used for both diagnosis and treatment. This procedure can be performed without anesthesia or under anesthesia. Purpose: This thesis study aims to investigate the efficiency of intraoperative lidocaine infusion, which is frequently preferred for surgical procedures, in reducing postoperative pain, nausea, and vomiting, as well as need for opioid analgesics and anti-emetics. Materials and Methods: This is a prospective review of 150 patients who are to undergo hysteroscopy for various indications. A total of 75 patients would be allocated to either research or control groups. Patients in the research group received 1% intravenous lidocaine at a dose of 0.15 ml/kg before the initiation of general anesthesia and the infusion of 1% lidocaine would be continued at a dose of 0.2 ml/kg/hour throughout the procedure. In the control group, 0.9% saline solution would be used instead of lidocaine. Postoperative pain would be evaluated by visual analog scale (VAS). Data related with postoperative pain, nausea and emesis as well as the need for postoperative analgesic and anti-emetic drugs were also recorded. Results: Compared with the control group, the patients in the research group had significantly lower usage and dosage of fentanyl which is an opioid anesthetic (p=0.001 for both). The patients in the research group had significantly lower VAS values measured at the 30th minute, 60th minute, 4th hour and 24th hour postoperatively (p = 0.001 for all). Postoperative nausea and emesis were also significantly lower in the research group (respectively p=0.031 and p=0.001). Conclusion: This study showed that intraoperative intravenous lidocaine infusion reduces postoperative pain, nausea, vomiting, and need for opioid analgesia in women undergoing hysteroscopy. Key Words: Pain, hysteroscopy, vomiting, lidocaine.