Papers by Geertrui Dewinter
Best Practice & Research Clinical Anaesthesiology
Regional anesthesia and pain medicine, Jan 12, 2016
Perioperative systemic lidocaine provides postoperative analgesia, decreases opioid consumption, ... more Perioperative systemic lidocaine provides postoperative analgesia, decreases opioid consumption, and facilitates rehabilitation in abdominal surgery. We hypothesized that systemic lidocaine has analgesic effects in women undergoing day-case laparoscopic sterilization. Eighty women were randomized in this prospective, double-blind trial to receive either lidocaine (intravenous bolus of 1.5 mg/kg at induction of anesthesia, followed by an infusion of 1.5 mg · kg · h, which was continued until 30 minutes after arrival at the postanesthesia care unit [PACU]) or placebo. The primary end point was the proportion of patients with a numeric rating scale (NRS) of greater than 3, 30 minutes after arrival at the PACU. Secondary outcomes included total opioid consumption, postoperative pain scores, incidence of postoperative nausea and vomiting, and time to readiness for discharge. This clinical trial was registered (Eudra CT 2011-001315-31). Thirty minutes after PACU admission, the proportion ...
The role of intravenous lidocaine in modern anesthesia: Lidocaine The effect of lidocaine on cogn... more The role of intravenous lidocaine in modern anesthesia: Lidocaine The effect of lidocaine on cognitive dysfunction: Wang et al. investigated the effects of lidocaine on early postoperative cognitive dysfunction after coronary artery bypass surgery. The authors concluded that the proportion of ESRA Abstracts
Trials, 2014
Despite the laparoscopic approach becoming the standard in colorectal surgery, postoperative pain... more Despite the laparoscopic approach becoming the standard in colorectal surgery, postoperative pain management for minimally invasive surgery is still mainly based on strategies that have been established for open surgical procedures. Patient-controlled epidural and intravenous analgesia are considered standard postoperative analgesia regimens in colorectal surgery. Epidural analgesia provides excellent analgesia, but is increasingly scrutinized in laparoscopic surgery since postoperative pain after the laparoscopic approach is significantly reduced. Moreover, epidural analgesia can be associated with numerous complications. Therefore, epidural analgesia is no longer recommended for the management of postoperative pain in laparoscopic colorectal surgery. Likewise, patient-controlled intravenous analgesia is subject to significant side effects. Given these important limitations of the traditional strategies for postoperative analgesia, effective and efficient alternatives in patients undergoing laparoscopic colorectal surgery are needed. Both the transversus abdominis plane block and systemically administered lidocaine have already been reported to effectively reduce pain after laparoscopic colorectal surgery. We hypothesize that the transversus abdominis plane block is superior to perioperative intravenous lidocaine. One hundred and twenty five patients undergoing laparoscopic colorectal surgery will be included in this prospective, randomized, double-blind controlled clinical trial. Patients will be randomly allocated to three different postoperative strategies: postoperative patient-controlled intravenous analgesia with morphine (control group, n = 25), a transversus abdominis plane block with ropivacaine 0.375% at the end of surgery plus postoperative patient-controlled intravenous analgesia with morphine (TAP group, n = 50), or perioperative intravenous lidocaine plus postoperative patient-controlled intravenous analgesia with morphine (LIDO group, n = 50). As the primary outcome parameter, we will evaluate the opioid consumption during the first 24 postoperative hours. Secondary endpoints include the Numeric Rating Scale, time to return of intestinal function, time to mobilization, inflammatory response, incidence of postoperative nausea and vomiting, length of hospital stay and postoperative morbidity as assessed with the Clavien-Dindo classification. Recognizing the importance of a multimodal approach for perioperative pain management, we aim to investigate whether a transversus abdominis plane block delivers superior pain control in comparison to perioperative intravenous lidocaine and patient-controlled intravenous analgesia with morphine alone. EudraCT Identifier: 2014-001499-73; 31 July 2014.
European journal of anaesthesiology, Jan 16, 2015
Postoperative nausea and vomiting (PONV) can be prevented. Alizapride is an established antiemeti... more Postoperative nausea and vomiting (PONV) can be prevented. Alizapride is an established antiemetic that may be effective in this role. Our primary objective was to test the hypothesis that alizapride is noninferior to ondansetron for the prophylaxis of PONV. A randomised, placebo-controlled, double-blinded noninferiority study. University hospitals of Leuven, Belgium, from November 2008 to July 2011. A total of 523 patients undergoing laparoscopic gynaecological surgery were included in the study. Reasons for exclusion were American Society of Anesthesiologists (ASA) greater than 2, hypersensitivity to the study medication, pregnancy, mental disorders, psychiatric illness or consumption of antiemetic drugs within 24 h before initiation of the study. Patients received either alizapride 100 mg, ondansetron 4 mg or placebo intravenously 30 min before the end of surgery. The main outcome measures included the incidences of postoperative nausea (PON) and postoperative vomiting (POV) duri...
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Papers by Geertrui Dewinter