Saadat Fakhr Masoud, Pakdaman Zahra, Rezvanfar Kiana, Shah Hosseini Reza, Amini Zahra, Amiri Koosha, Narimani Zamanabadi Mahnaz
Faculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
Medical Student, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Pain Manag. 2025 Oct;15(10):677-683. doi: 10.1080/17581869.2025.2539668. Epub 2025 Jul 26.
Effective postoperative pain management remains a critical challenge, particularly in lower abdominal surgeries where multimodal approaches are underexplored. This study aimed to evaluating the efficacy of this combination in reducing pain and analgesic requirements.
In this double-blind, randomized controlled trial, 59 patients undergoing elective lower abdominal surgery were randomly assigned to receive either subcutaneous metoclopramide plus lidocaine or lidocaine alone after surgery. Postoperative pain scores were assessed at 1, 6, 12, and 24 hours using the Visual Analog Scale (VAS), and analgesic consumption was recorded over the first 24 hours.
59 patients (mean age: 41.8 ± 11.8 years; 43.1% male, 56.9% female) receiving the metoclopramide-lidocaine combination demonstrated significantly lower pain scores at all assessed time points compared to lidocaine alone, with values of 5.2 ± 1.1 versus 7.7 ± 0.8 at 1 hour, 3.8 ± 0.9 versus 6.2 ± 0.9 at 6 hours ( = 0.004), 2.9 ± 1.0 versus 5.4 ± 1.4 at 12 hours, and 2.1 ± 0.7 versus 4.4 ± 1.1 at 24 hours postoperatively ( < 0.001). Furthermore, the combination group showed a 28.6% reduction in analgesic requirements during the first 24 hours (47.4 ± 18.1 mg vs 66.3 ± 25.2 mg, = 0.002), highlighting the opioid-sparing effect of this approach.
The addition of metoclopramide to subcutaneous lidocaine resulted in improved postoperative pain control and reduced analgesic requirements following lower abdominal surgeries under general anesthesia.
Iranian Registry of Clinical Trials identifier is IRCT20231228060548N1.
有效的术后疼痛管理仍然是一项严峻挑战，尤其是在下腹部手术中，多模式方法尚未得到充分探索。本研究旨在评估这种联合用药在减轻疼痛和镇痛需求方面的疗效。
在这项双盲、随机对照试验中，59例接受择期下腹部手术的患者在术后被随机分配接受皮下注射胃复安加利多卡因或仅接受利多卡因。使用视觉模拟量表（VAS）在术后1、6、12和24小时评估术后疼痛评分，并记录前24小时的镇痛药物消耗量。
与单独使用利多卡因相比，接受胃复安 - 利多卡因联合用药的59例患者（平均年龄：41.8±11.8岁；男性43.1%，女性56.9%）在所有评估时间点的疼痛评分均显著更低，术后1小时分别为5.2±1.1和7.7±0.8，6小时为3.8±0.9和6.2±0.9（P = 0.004），12小时为2.9±1.0和5.4±1.4，24小时为2.1±0.7和4.4±1.1（P < 0.001）。此外，联合用药组在前24小时的镇痛需求减少了28.6%（47.4±18.1毫克对66.3±25.2毫克，P = 0.002），突出了这种方法的阿片类药物节省效应。
在皮下注射利多卡因中添加胃复安可改善全身麻醉下下腹部手术后的术后疼痛控制并减少镇痛需求。
伊朗临床试验注册中心标识符为IRCT20231228060548N1。
