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- W2080327115 abstract "Introduction: Endoscopic resection (ER) is becoming a standard treatment for early gastric cancer (EGC) and nowadays is being performed in an increasing number of patients. Although the complications of the method like bleeding, perforation and significant pain are rare, their prevalence will accordingly increase in the future. A decrease of post ER pain would lead to its wider acceptance. Recent evidence suggests that instillation of local anesthetic both into the peritoneum and the skin incision may be beneficial in minimally invasive surgery such as laparoscopic cholecystectomy. There is no report on lidocaine use during ER, for post-ER analgesia. Aim&Methods: We attempted to reduce the percentage of patients experiencing significant pain by means of local anesthesia injection. We evaluated the action of lidocaine when injected into submucosa during ER. We randomized 17 patients (12 males, age range 51∼80) who underwent ER for early gastric cancer from September to November in 2005, in 2 groups; 8 patients received 0.5% lidocaine with epinephrine while 9 received saline with epinephrine as placebo. All procedures were carried out under standard sedation (midazolam, pentazocine). The patients, operator, and assistant were blinded on the nature of the injected agent. During the procedure we monitored ECG, heart rate, oxygen saturation, and blood pressure. The patients reported the level of pain felt on days 0, 1 and 2 after the procedure and on the same time blinded doctors examined them physically focusing on the existence of epigastric discomfort and tenderness. The level of white blood cell and C-reactive protein was also recorded. Results: No abnormality on ECG, heart rate, oxygen saturation, and blood pressure was seen in any patient of either group. Only one patient out of the eight of the lidocaine group presented abdominal findings contrasting to three patients out of nine in the saline group on day 0. The mean dosage of midazolam necessitated in the lidocaine group (8.5 mg/person) was lower from the one in the placebo group (11.6 mg/person). The dosage of pentazocine was similar. Mean dosage of lidocaine was 195 mg. No episode of lidocaine intoxication, convulsion or arrhythmia was seen. In particular, when the resected tumors were located in the antrum, 40% of the patients belonging to the saline group had abdominal findings at day 0 as compared to none of the lidocaine group. Conclusion: Lidocaine injection into submucosal layer during ER seems to be safe and to reduce pain in the immediate post ER period. Its efficacy should be further investigated." @default.
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- W2080327115 date "2006-04-01" @default.
- W2080327115 modified "2023-09-25" @default.
- W2080327115 title "Use of Lidocaine Injection During Endoscopic Resection for Early Gastric Cancer" @default.
- W2080327115 doi "https://doi.org/10.1016/j.gie.2006.03.465" @default.
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