Perioperative lidocaine infusions have demonstrated benefits for improving analgesia and recovery after laparoscopic abdominal surgery. In patients with obesity, using multi-modal and non-opioid adjuncts such as lidocaine infusion, may reduce opioid-related complications. However, there are inconsistencies with lidocaine infusions dosing regimens with concerns for safety and efficacy, particularly when using a weight-based protocol in patients with obesity. Optimising the dosing of lidocaine is important to balance the risk-benefit profile and ultimately improve outcomes of this increasing surgical population.
Our previous research demonstrated that current lidocaine infusions are likely to achieve sub-therapeutic concentrations in patients with obesity. Using pharmacokinetic analysis and dosing simulations, we developed an infusion regimen that more optimally achieves (simulated) plasma concentrations within the therapeutic and non-toxic range. This new study will prospectively evaluate our optimised lidocaine infusion for safety and efficacy in patients with obesity undergoing elective laparoscopic abdominal surgery at the Royal Brisbane and Women’s Hospital. Pharmacokinetic analysis will determine if this infusion achieves targeted therapeutic plasma concentrations without high peak concentrations. We will also evaluate important patient-focused outcome measures, including pain scores, post-operative recovery and length of stay. If safe and effective, the proposed regimen will be evaluated in a randomised controlled trial.
Dr Angela Tognolini, Professor Victoria Eley, The Royal Brisbane and Women’s Hospital, Professor Jason Roberts, The University of Queensland Centre for Clinical Research, Brisbane.
The project was awarded A$90,000 funding through the ANZCA research grants program for 2026.