الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
T
he administration of lidocaine and dexmedetomidine decreases the postoperative pain scores and reduces the total opioid consumption.
Perioperative pain management and analgesia become challenges to anesthesiologist during abdominal surgery. However, multimodal intraoperative analgesia is required to provide optimal postoperative analgesia, less complications and better perioperative outcomes, facilitates fast-track perioperative care and could lead to significant changes in the standard of care in anesthesia.
SUMMARY
D
espite the improvement in anesthetic and surgical techniques, post-operative complications remain one of the major drawbacks in many surgical procedures.
ERAS is a perioperative multimodal pathway that has been established to improve patient outcome, speed up recovery time and reduce the length of hospitalization after surgical operations.
Opioids are the most commonly used drugs to control preoperative pain; however, they have a well-known undesirable side effect. Therefore, it should be limited to ERAS pathway to reduce mortality and morbidity.
Many pharmacological agents used in modern anesthesia are used to decrease the undesirable side effects of opioids, such as respiratory depression, delayed recovery, post-operative ileus, nausea and vomiting.
Dexmedetomidine is an opioid spearing alpha 2 adrenergic agonists recently used as a part of multimodal analgesia to facilitate the ERAS pathway.
Lidocaine is a weak base, amino amide local anesthetic which is widely used as an anti-inflammatory and hyperal&esic.
It is an effective drug additive with a clear benefit in the ERAS pathway to improve the outcome.
Our study aimed to compare the effect of dexmedetomidine and lidocaine as an adjuvant to balanced general anesthesia and their role in enhanced recovery after abdominal surgery.
The effect of both drugs on hemodynamics and monitoring the occurrence of any complications were also done.
In our study, 140 patients were randomly divided into two groups; Dexmedetomidine (group D) received a 1ug/kg loading dose over 10 minutes followed by 0.5ug/kg/hr. while lidocaine (group L) received 1.5mg/kg over 5 minutes loading dose followed by 1mg/kg/hr. Both infusions are continued 24 hr. post bolus dose.
Our study showed that lidocaine has greater intraoperative hemodynamic stability than dexmiditomidine. In addition, it has lower post-operative side effects regarding PONV and ileus than dexmedetomidine.
Regarding postoperative VAS score and total consumption of opioids, the two groups were statistically insignificant. Making lidocaine more superior than dexmedetomidine when chosen as an analgesic adjuvant to balanced general anesthesia in a patient undergoing open abdominal surgery.