Abstract
Objective
To determine whether local infiltration using short-acting local anesthetic lidocaine in different concentrations before the surgical incision could reduce pain postoperatively in patients undergoing bilateral video- assisted thoracoscopic sympathectomy.
Methods
A total of 72 patients who underwent bilateral video-assisted thoracoscopic sympathectomy were included in this controlled double blind prospective study which was conducted at King Hussein Medical Center, Amman, Jordan from January 2009 to January 2011. The study enrolled patients of both genders (males 41 and females 31), aged 18-44 years, and with American Society of Anesthesiologists (ASA) class I- II. They were consecutively randomized into two groups with 36 patients in each group. All patients received pre-incision lidocaine local infiltration on one side with different concentrations and volumes (1% group A, 2% group B), and on the other side we used normal saline solution. Verbal rating scale (VRS) was used to assess the intensity of postoperative pain. Intensity of pain and the duration of analgesia were compared between the two groups. Data collection was done using a questionnaire and was analyzed by student t-test. P<0.05 was considered statistically significant.
Results
The average duration of analgesia in group A was 3 hours and 25 minute, while in group B it was 4 hours and 45 minute. On the other side, which was infiltrated with normal saline solution, it was about one hour only.
Conclusion
Preincisional infiltration with 2% lidocaine was an effective and simple approach for postoperative pain relief after thoracoscopic sympathectomy. (Rawal Med J 2012;37:27-29).

Key words: Analgesia, lidocaine, Local infiltration, Thoracoscopy, sympathectomy