Intraoperative Lidocaine Infusion

Laparoscopic cholecystectomy is considered a minimally invasive procedure; however, it still provokes a measurable systemic inflammatory response. This reaction is primarily driven by factors such as tissue manipulation, peritoneal insufflation, and surgical stress. C-reactive protein (CRP), a widely validated acute-phase reactant, serves as a reliable biomarker to monitor postoperative inflammation, typically peaking within 24 to 48 hours following surgery. Other inflammatory markers such as white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), and interleukin-6 (IL-6) also exhibit perioperative changes, reflecting the underlying cytokine-mediated stress response. Monitoring these biomarkers provides insight into the extent of tissue injury and can help predict postoperative recovery or complications. Therefore, modulating the inflammatory response-such as through intravenous lidocaine infusion-may improve postoperative outcomes, including pain control, gastrointestinal recovery, and length of hospital stay.

Inclusion criteria

• Patients aged 18 - 60 years
• Elective laparoscopic cholecystectomy for symptomatic cholelithiasis or chronic cholecystitis
• ASA physical status I-II
• BMI < 35 kg/m2
• Preoperative CRP <20 mg/L
• Informed consent provided

Exclusion criteria

• Acute cholecystitis or biliary pancreatitis
• Conversion to open surgery
• Pre-op CRP >20 mg/L
• Allergy to lidocaine or local anesthetics
• Known hepatic or renal dysfunction
• Chronic inflammatory conditions
• Current immunosuppressive therapy
• Cardiac arrhythmias or heart block without pacemaker
• ASA physical status III, IV or above
• Pregnancy or breastfeeding
• Psychiatric disorders