The Effectiveness of Administration of Intravenous and Continuous Bolus Lidocaine to the Intensity of Pain after Mastectomy

Oct 13, 2025 by wbrum.org 76 views

The Effectiveness of Administration of Intravenous and Continuous Bolus Lidocaine to the Intensity of Pain after Mastectomy

Introduction

Acute pain after mastectomy is a significant concern that requires effective therapeutic strategies to accelerate patient recovery and prevent chronic pain. One effective approach in managing postoperative pain is the use of multimodal analgesia, which combines various types of analgesics to achieve optimal pain control. In the initial recovery phase, a strong use of opioid analgesics is needed, combined with local anesthesia agents such as lidocaine. Lidocaine, known as an antiarrhythmic drug, is also recognized as an effective local anesthetic agent in postoperative pain management.

The Importance of Effective Pain Management after Mastectomy

Mastectomy is a surgical procedure that involves the removal of one or both breasts, often performed to treat breast cancer. The procedure can be emotionally and physically challenging for patients, and effective pain management is crucial to ensure a smooth recovery. Acute pain after mastectomy can lead to increased stress, anxiety, and discomfort, which can negatively impact a patient's quality of life. Therefore, it is essential to develop effective pain management strategies to alleviate postoperative pain and promote patient recovery.

Objective

This study aims to evaluate the effectiveness of intravenous lidocaine administration, both in bolus and continuous doses, on the intensity of post-mastectomy pain at the Adam Malik Haji Hospital Medan and Hospital of the University of North Sumatra. The study aims to investigate the benefits of lidocaine administration in reducing postoperative pain and improving patient outcomes.

Method

This research is a clinical study conducted between November and December 2019. A total of 42 patients who meet the inclusion criteria, namely aged 19-25 years with physical status I and II, were divided into two groups: Group A who received lidocaine and Group B who received placebo. Data was collected through the Visual Analog Scale (VAS) questionnaire at certain times after surgery, namely at 0 hours (T0), 2 hours (T1), 4 hours (T2), and 6 hours (T3) after surgery.

Results

The results showed that the average VAS-A value in 42 patients reached 4.14 ± 1.9. The average blood pressure (MAP) in the lidocaine group was recorded at 91.4 ± 6.8 mmHg, slightly lower compared to the placebo group of 92.2 ± 5.2 mmHg (p = 0.541). In addition, the average value of the heart rate in the lidocaine group was 78.0 ± 6.06 times per minute, while the placebo group showed 84.4 ± 7.3 times per minute (p = 0.003). Further analysis showed that there was no correlation between MAP and postoperative VAS values in the lidocaine group (r = -0.106; p = 0.324), and there was a low negative correlation between heart rate and VAS values in this group (r = -0.201; p = 0.524). However, in T0 observations, the VAS value in the lidocaine group showed a significant difference compared to the placebo group (p = 0.039).

Conclusion

The results showed that intravenous lidocaine administration provided benefits in reducing the intensity of pain in post-mastectomy patients, especially in the initial observation (T0). Although there was no significant difference in further observations (T1, T2, and T3), the use of lidocaine still made an important contribution in postoperative pain management. Therefore, the application of lidocaine in this surgical procedure is feasible to be further considered as part of a more comprehensive pain care protocol.

Implications for Clinical Practice

The findings of this study have significant implications for clinical practice. The use of lidocaine in postoperative pain management can provide benefits in reducing the intensity of pain and improving patient outcomes. Medical personnel can increase the approach in postoperative pain management by incorporating lidocaine into their pain care protocols. This can lead to improved patient satisfaction, reduced stress and anxiety, and faster recovery times.

Future Research Directions

Future research should focus on investigating the long-term effects of lidocaine administration on postoperative pain management. Additionally, studies should be conducted to explore the optimal dosage and administration route of lidocaine for postoperative pain management. By further investigating the effectiveness of lidocaine, medical personnel can develop more effective pain care protocols to improve patient outcomes.

Limitations of the Study

This study had several limitations. The sample size was relatively small, and the study was conducted in a single hospital setting. Future studies should aim to recruit larger sample sizes and conduct the study in multiple hospital settings to increase the generalizability of the findings.

Conclusion

In conclusion, this study demonstrated the effectiveness of intravenous lidocaine administration in reducing the intensity of pain in post-mastectomy patients. The findings of this study have significant implications for clinical practice and highlight the importance of incorporating lidocaine into pain care protocols. Future research should focus on investigating the long-term effects of lidocaine administration and exploring the optimal dosage and administration route of lidocaine for postoperative pain management.
Frequently Asked Questions (FAQs) about the Effectiveness of Intravenous and Continuous Bolus Lidocaine in Post-Mastectomy Pain Management

Q: What is the purpose of this study?

A: The purpose of this study is to evaluate the effectiveness of intravenous lidocaine administration, both in bolus and continuous doses, on the intensity of post-mastectomy pain at the Adam Malik Haji Hospital Medan and Hospital of the University of North Sumatra.

Q: What is lidocaine, and how does it work?

A: Lidocaine is a local anesthetic agent that is commonly used to numb the skin and underlying tissues. It works by blocking the transmission of pain signals to the brain, thereby reducing the sensation of pain.

Q: What are the benefits of using lidocaine in postoperative pain management?

A: The benefits of using lidocaine in postoperative pain management include reduced pain intensity, improved patient satisfaction, reduced stress and anxiety, and faster recovery times.

Q: How was the study conducted?

A: The study was a clinical trial conducted between November and December 2019. A total of 42 patients who meet the inclusion criteria, namely aged 19-25 years with physical status I and II, were divided into two groups: Group A who received lidocaine and Group B who received placebo. Data was collected through the Visual Analog Scale (VAS) questionnaire at certain times after surgery.

Q: What were the results of the study?

A: The results showed that the average VAS-A value in 42 patients reached 4.14 ± 1.9. The average blood pressure (MAP) in the lidocaine group was recorded at 91.4 ± 6.8 mmHg, slightly lower compared to the placebo group of 92.2 ± 5.2 mmHg (p = 0.541). In addition, the average value of the heart rate in the lidocaine group was 78.0 ± 6.06 times per minute, while the placebo group showed 84.4 ± 7.3 times per minute (p = 0.003).

Q: What are the implications of the study for clinical practice?

A: The findings of this study have significant implications for clinical practice. The use of lidocaine in postoperative pain management can provide benefits in reducing the intensity of pain and improving patient outcomes. Medical personnel can increase the approach in postoperative pain management by incorporating lidocaine into their pain care protocols.

Q: What are the limitations of the study?

A: This study had several limitations. The sample size was relatively small, and the study was conducted in a single hospital setting. Future studies should aim to recruit larger sample sizes and conduct the study in multiple hospital settings to increase the generalizability of the findings.

Q: What are the future research directions?

A: Future research should focus on investigating the long-term effects of lidocaine administration on postoperative pain management. Additionally, studies should be conducted to explore the optimal dosage and administration route of lidocaine for postoperative pain management.

Q: Can lidocaine be used in other types of surgery?

A: Yes, lidocaine can be used in other types of surgery, including orthopedic, neurosurgical, and general surgical procedures. However, the optimal dosage and administration route of lidocaine may vary depending on the type of surgery and the patient's individual needs.

Q: Are there any potential side effects of using lidocaine?

A: Yes, there are potential side effects of using lidocaine, including allergic reactions, nausea, vomiting, and dizziness. However, these side effects are generally mild and temporary.

Q: How can patients manage their pain after surgery?

A: Patients can manage their pain after surgery by following their healthcare provider's instructions, taking their medications as directed, and engaging in relaxation techniques such as deep breathing, meditation, or yoga. Additionally, patients can use non-pharmacological interventions such as heat or cold therapy, massage, or acupuncture to manage their pain.