The effects of ketamine-lidocaine infusion and lidocaine infusion on postoperative pain, nausea-vomiting, shivering and recovery in laparoscopic minimal gynecologic surgeries

Evaluation of the Effects of Perioperative Ketamine-Lidocaine Infusion Versus Lidocaine Infusion on Postoperative Pain, Nausea-Vomiting, Shivering, and Recovery in Laparoscopic Minimally Invasive Gynecological Surgeries Laparoscopic minimally invasive gynecological surgeries are widely performed today, offering advantages such as reduced postoperative pain, less blood loss, and faster recovery. However, postoperative pain management remains a significant challenge for clinicians. In our clinic, the efficacy of analgesic agents with two different mechanisms of action was retrospectively evaluated in line with multimodal analgesia principles. Data from patients who received perioperative lidocaine infusion and those who received a combination of ketamine and lidocaine infusion were analyzed. The findings revealed that the combined use of these agents was associated with effective analgesia, fewer complications, and improved recovery quality. In ketamine-lidocaine infusion applied group, compared to the lidocaine-only group, there was no significant change in extubation and recovery times. However, higher QoR-15 recovery quality scores, reduced need for rescue analgesics, lower postoperative VAS scores, lower shivering scores, and decreased incidence of nausea and vomiting were observed up to 24 hours postoperatively. Although this study has some limitations due to its retrospective design, it showss that the combination of ketamine and lidocaine has the potential to improve postoperative outcomes in laparoscopic surgeries. According to our literature review, this is the first study to compare the combination of ketamine and lidocaine with lidocaine alone in terms of recovery quality. Prospective, randomized controlled studies are needed to investigate the applicability of this combination in other surgical fields.