CONTACT:
Richard Puff
Albany Medical Center, Albany, NY
518-262-3421
[email protected]
EMBARGOED UNTIL: 5 p.m. (EST) October 21, 1997
SAN DIEGO, Oct. 21, 1997 ≠The use of an inexpensive anesthetic during and immediately after prostate surgery might be able to reduce hospital stay and dramatically reduce the amount of pain a patient experiences, according to an Albany Medical College study to be presented today at the annual meeting of the American Society of Anesthesiologists.
Scott Groudine, M.D., assistant professor of anesthesiology and surgery, provided an intravenous dose of the numbing anesthetic lidocaine ã with a pharmacy cost of $2.89 ã to 20 patients about to undergo a radical prostatectomy. The group also received the medication in the recovery room for one hour after surgery. Another group of 20 radical prostatectomy patients received no lidocaine.
≥Whatπs most impressive is that the patients receiving lidocaine had a two-thirds reduction in total pain during their hospital stay, even though the blood levels of the lidocaine disappear after a few hours,≤ said Dr. Groudine. ≥The patients who received the lidocaine infusion also were discharged from the hospital an average of 1.1 days sooner.≤
Each day after surgery, the patients scored their pain on a scale from 0 to 10, the higher the score indicating the worse the level of pain.
Dr. Groudine suggested that the significant reduction in pain and shorter hospital stays could be due to another effect of the lidocaine: the quicker end to postoperative ileus, or the inability of the bowels to function properly.
≥Ileus can be a painful and potentially expensive result of surgery, stress or trauma. The cost of postoperative ileus has been estimated at $750 million annually,≤ Dr. Groudine noted.
Ileus is a common reaction when the bowel is touched or moved during abdominal surgery or as the result of trauma. Most surgeons will not allow their patients to leave the hospital after a surgical procedure until they have some sign of a return of normal bowel function.
≥Lidocaine, which has a long safety record, seems to block the nerve impulses and the inflammatory process that may prolong ileus,≤ Dr. Groudine said. ≥Blocking these interactions before the start of surgery might result in a faster return of bowel function which could lead to a higher level of patient comfort, earlier feeding and earlier discharge.≤
The group receiving lidocaine had their first flatus ã or passing of gas ã approximately one-third faster than the other group (28.5 hours after surgery as compared to 42.1 hours). This group also had their first bowel movement 12 hours earlier (61.8 hours versus 73.9 hours) than the non-lidocaine group.
≥The return of normal bowel function is an important step in the recovery of postoperative patients and this study demonstrates that a lidocaine infusion can have an impressive effect on pain, bowel function and hospital stay,≤ Dr. Groudine said.
Lidocaine treatment now has become commonplace for radical prostatectomies by the Medical Collegeπs urology surgeons. Dr. Groudine and his colleagues at Albany Medical College plan to extend the lidocaine treatment to other gastrointestinal surgeries. During a recent colon surgery, for example, a patient received lidocaine prior to the procedure and suffered from ileus for only two days, Dr. Groudine said. The same patient had ileus for 12 days after a similar surgery several years before.
≥This seems to be a low-cost, low-risk intervention that has a pronounced effect on the patientπs recovery,≤ Dr. Groudine said. ≥In this regard, it shows that what anesthesiologists do in the operating room can have a significant and long-reaching effect on patient comfort and health-care costs. Itπs very exciting.≤
Dr. Groudineπs research also has been accepted for publication in Anesthesia and Analgesia: The Journal of the International Anesthesia Research Society.
Albany Medical College co-authors with Dr. Groudine include Hugh A.G. Fisher, M.D., associate professor of surgery; Ronald Kaufman, M.D., assistant professor of surgery; Manoj K. Patel, a medical student at the college; Sudha Mehta, M.P.H., research assistant and statistician; and Philip D. Lumb, M.B.B.S., professor and chairman of anesthesiology. Lance J. Wilkins, M.D., an attending anesthesiologist at the U.S. Naval Hospital in Pensacola, Fla., collaborated on the study.
Albany Medical College, which was founded in 1839, is an institution of the Albany Medical Center, the only academic health sciences center in northeastern New York and western New England. The Medical Center also includes the 651-bed Albany Medical Center Hospital; the Albany Medical Center Faculty Group Practice; and the Albany Medical Center Foundation, Inc.
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