Effect of Topical Lidocaine Patch on Postoperative Pain Management in Laparoscopic Appendectomy: A Randomized, Double-Blind, Prospective Study

Background: Adequate pain control is a major concern in the immediate postoperative period. In multiple strategies for postoperative pain management, topical analgesics have significant advantages of minimizing severe side effects caused by oral and parenteral administration and drug-drug interactions. Therefore, we studied the effect of lidocaine patch on postoperative pain control in laparoscopic appendectomy. Patients and Methods: This randomized double-blind prospective controlled study enrolled 40 acute appendicitis cases that were treated by laparoscopic appendectomy and randomly divided into two groups. Lidocaine patches containing lidocaine 175mg was applied to the umbilical trocar site of each patient, and pain intensity was assessed with the visual analog scale every 6 hours up to 48 hours after laparoscopic appendectomy. Results: There was no significant difference in age, gender, body mass index, the American society of anesthesiologists score, comorbidity, or underlying disease between the lidocaine patch and control groups. The postoperative pain scores were lower in the lidocaine patch group than in the control group, but statistical significance was not noted at the trocar site or the right lower quadrant of the abdomen (P=.320 and P=.903, respectively). The mean amounts of pethidine used after surgery were significantly smaller in the lidocaine patch group than in the control group (0.100.31mg versus 0.25 +/- 0.79mg, P<.001). Conclusions: The results of this study suggest that lidocaine patch application to the trocar site after laparoscopic appendectomy may have a positive effect on the management of postoperative pain and can eliminate the need to inject additional analgesics for further postoperative pain control.