Intraoperative intravenous lidocaine for analgesia after oral cancer surgery with free perforator flap reconstruction: a randomised controlled trial. Download PDF Abstract Intravenous lidocaine is effective in various surgical procedures, but its efficacy in oral cancer surgery is uncertain. We hypothesised that intraoperative intravenous lidocaine infusion can reduce 24-hour postoperative opioid consumption and reduce postoperative pain in patients undergoing oral cancer surgery with free perforator flap reconstruction.
In this blinded, randomised, placebo-controlled trial, a total of 64 patients scheduled for elective oral cancer surgery with free perforator flap reconstruction were enrolled and randomly assigned to either the lidocaine group receiving intravenous lidocaine, or the control group receiving normal 0.9% saline. The primary outcome was the cumulative consumption of opioids at the first 24 h postoperatively. Secondary outcomes included the cumulative consumption of opioid drugs intraoperatively within 48 h and 72 h postoperatively, NRS scores at 24, 48, and 72 h postoperatively, lidocaine-related adverse events, incidence of chronic pain and neuropathic pain at 3 months postoperatively.
From August 2024 to December 2024, a total of 102 patients were screened for eligibility, 64 patients were included. Baseline characteristics and surgery-related data were similar between the two groups. Median (IQR) 24-h morphine equivalent consumption was 43.38 (37.60, 47.45) mg in the lidocaine group vs.
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