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Master Thesis

Efficacité et sécurité de la lidocaïne intraveineuse en postopératoire de chirurgie cardiaque : une étude rétrospective

Abstract : Introduction : Intravenous lidocaine has analgesic activity, used in postoperative surgery providing moderate and intense pain. It is known to allow morphine savings in abdominal and gynecological surgery. The purpose of our study is to evaluate the postoperative efficacy of cardiac surgery. Methods: The protocol for postoperative cardiac surgery analgesia with cardiopulmonary bypass in the cardiac surgery department of Rennes combines paracetamol, nefopam and morphine with a continuous flow rate of 0.2 to 1 mg per hour adapted according to the pain score with bolus (NCA). During the month of September 2017, the protocol was substituted: the continuous flow of morphine was replaced by infusion of lidocaine (bolus at the begining of surgery: 1 mg.kg-1 then 1 mg.kg-1.h-1) until chest tubes and mediastinal tubes were removed . Over this transition period, data from 90 patients were collected, 45 patients receiving infusion of lidocaine (LIDO +) and 45 patients receiving infusion of morphine (LIDO-). The results are expressed in median [interquartile 25-75]. The primary endpoint is total morphine consumption in intensive care during first 48 hours. The statistical analysis is performed by Mann - Whitney test. Results: Morphine consumption was significantly higher in LIDO - group during first 48 hours with 32 mg [24-39.5] versus 4 mg [0-9] (p <0.01). There was no significant difference on pain scores. Conclusion: The use of lidocaine infusion in postoperative care of cardiac surgery allows significant morphine savings in comparison with continuous administration of morphine.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02139496
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Submitted on : Friday, May 24, 2019 - 5:24:35 PM
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Matthieu Arnouat. Efficacité et sécurité de la lidocaïne intraveineuse en postopératoire de chirurgie cardiaque : une étude rétrospective. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02139496⟩

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