[Intraoperative continuous epidural lidocaine combined with preoperative administration of epidural morphine for post-hepatectomy pain relief].

In a randomized double-blind study, the use of continuous epidural lidocaine during surgery combined with preoperative epidural morphine was compared with that of preoperative epidural morphine alone for postoperative analgesia in 20 patients undergoing hepatectomy. Morphine 2 mg was administered through a catheter inserted epidurally at T10-11 before surgery, followed by continuous epidural administration of 1% lidocaine 5ml.h-1 in group Lid (n = 10) or normal saline 5ml.h-1 in group NS (n = 10) during surgery. Anesthesia was maintained with N2O-O2-isoflurane in both groups. On admission to the ICU, the visual analog scale score (VAS; mm) was 20 +/- 7 (mean +/- SE) in group Lid and 38 +/- 10 in group NS, and the number of patient with VAS < or = 30 was 9 in group Lid and 4 in group NS; these differences were significant (P < 0.05). Pain score during mobilization in group Lid was significantly lower than that in group NS (P < 0.05). All patients in both groups had adequate analgesia for the remainder of their stay in the ICU. No patient had any serious adverse effect. We conclude that continuous epidural administration of lidocaine during hepatectomy combined with administration of epidural morphine just before surgery results in better pain relief during the early postoperative period than that obtained with epidural morphine alone, and is without serious side effects.