Efecto Analgésico Postoperatorio de la Lidocaína Transoperatoria en Colecistectomía Laparoscópica
Palabras clave:
colecistectomía laparoscópica, lidocaína, dolor postoperatorio, analgesia de rescate, analgesia multimodal
Resumen
La lidocaína intravenosa transoperatoria se ha propuesto como coadyuvante de la analgesia multimodal en colecistectomía laparoscópica, aunque su beneficio no es uniforme entre estudios. El objetivo fue evaluar la asociación entre la administración intravenosa transoperatoria de lidocaína y el requerimiento de analgesia de rescate durante las primeras 48 horas postoperatorias en pacientes sometidos a colecistectomía laparoscópica. Se realizó un estudio cuantitativo, observacional y analítico, de cohorte retrospectiva, en el Hospital General de Zona No. 46 del Instituto Mexicano del Seguro Social, en Villahermosa, Tabasco; se revisaron 90 expedientes de pacientes operados entre enero y agosto de 2024 (43 con lidocaína y 47 sin ella). Se estimaron riesgos relativos (RR) con intervalos de confianza al 95% (IC95%) y se ajustó con regresión de Poisson con varianza robusta. Predominó el sexo femenino (84.4%) y la mediana de edad fue de 55 años. La colecistitis litiásica agudizada se presentó en el grupo sin lidocaína en 91.5% de los casos y en el grupo con lidocaína en 11.6%. El rescate fue menor en el grupo con lidocaína (11.6% frente a 46.8%; RR=0.248; IC95%: 0.103–0.598, p <0.001); mientras que el uso de cuatro puertos se asoció con mayor riesgo de rescate (RR ajustado=1.913; IC95%: 1.028–3.561, p 0.041). El tramadol fue el fármaco de rescate más utilizado. La menor necesidad de rescate observada con lidocaína dependió en buena parte de la distribución desigual del diagnóstico entre los grupos, por lo que no es posible atribuirle un efecto independiente.
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Abreu-Pires, M., Cavaleiro, C., Machado, H., & Moreira da Silva, Á. (2025). Clarifying the postsurgical persistent pain after laparoscopic cholecystectomy and the role of intravenous lidocaine. Pain Reports, 10(6), e1347. https://doi.org/10.1097/PR9.0000000000001347
Alvarez Tiburcio, Z. P., Gonzalez Gomez, K. D., Ordaz Alvarez, H. R., Vargas Basurto, J. L., Perez Morales, A. G., Castellanos Juarez, J. C., Avila Mercado, O., Carrasco Arroniz, M. A., Suarez Alvarez, J. L., Rosario, G. V., Montes Osorio, Z. E., Sempe Minvielle, J., Hernandez Espinoza, R., Cano Contreras, A. D., & Roesch Dietlen, F. B. (2026). Assessment of safety and errors in laparoscopic cholecystectomy in the treatment of gallstone disease in southeastern Mexico. Journal of Clinical Medicine, 15(13), 4869. https://doi.org/10.3390/jcm15134869
Atter, M., Stoddart, A., Cotton, S., Vadiveloo, T., Innes, K., Balfour, A., Arnott, R., Aucott, L., Batham, Z., Foo, I., MacLennan, G., Nimmo, S., Speake, D., Norrie, J., & Paterson, H. (2025). Intravenous lidocaine for gut function recovery in colonic surgery: A health economic evaluation of the ALLEGRO randomised clinical trial. BMJ Open, 15(2), e088298.
https://doi.org/10.1136/bmjopen-2024-088298
Awan, B., Elsaigh, M., Elkomos, B. E., Sohail, A., Asqalan, A., Baqar, S. O. M., Elgendy, N. A., Saleh, O. S., Szul, J. M., Juan, A. S., Alasmar, M., & Marzouk, M. M. (2024). The use of lidocaine infusion in laparoscopic cholecystectomy: An updated systematic review and meta-analysis. Journal of Minimal Access Surgery, 20(3), 239–246. https://doi.org/10.4103/jmas.jmas_265_23
Bourgeois, C., Oyaert, L., Van de Velde, M., Pogatzki-Zahn, E., Freys, S. M., Sauter, A. R., Joshi, G. P., & Dewinter, G. (2024). Pain management after laparoscopic cholecystectomy: A systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations. European Journal of Anaesthesiology, 41(11), 841–855.
https://doi.org/10.1097/EJA.0000000000002047
Dai, Y., Huang, J., & Liu, J. (2024). Effects of intravenous lidocaine on postoperative pain and gastrointestinal function recovery following gastrointestinal surgery: A meta-analysis. Minerva Anestesiologica, 90(6), 561–572. https://doi.org/10.23736/S0375-9393.24.17920-5
Foo, I., Macfarlane, A. J. R., Srivastava, D., Bhaskar, A., Barker, H., Knaggs, R., Eipe, N., & Smith, A. F. (2021). The use of intravenous lidocaine for postoperative pain and recovery: International consensus statement on efficacy and safety. Anaesthesia, 76(2), 238–250.
https://doi.org/10.1111/anae.15270
Foong, K. W., Chaw, S. H., Lo, Y. L., & Loh, P. S. (2024). Population pharmacokinetics of intravenous lidocaine in adults: A systematic review. Clinical Pharmacokinetics, 63(5), 623–643.
https://doi.org/10.1007/s40262-024-01373-4
Freys, S. M., Pogatzki-Zahn, E. M., Rawal, N., & Joshi, G. P. (2025). The role of surgical techniques in reducing postoperative pain in abdominal surgery: Evidence from the PROSPECT systematic reviews. World Journal of Surgery, 49(11), 3081–3089. https://doi.org/10.1002/wjs.70091
Gallaher, J. R., & Charles, A. (2022). Acute cholecystitis: A review. JAMA, 327(10), 965–975.
https://doi.org/10.1001/jama.2022.2350
Hernán, M. A., Wang, W., & Leaf, D. E. (2022). Target trial emulation: A framework for causal inference from observational data. JAMA, 328(24), 2446–2447.
https://doi.org/10.1001/jama.2022.21383
Lapisatepun, W., Nitayamekin, A., Leurcharusamee, P., Pianngarn, I., Maykanggoon, K., Chotirosniramit, A., Junrungsee, S., Sandhu, T., Ko-Iam, W., & Lapisatepun, W. (2022). Efficacy of intravenous versus intraperitoneal lidocaine for postoperative analgesia in laparoscopic cholecystectomy: A randomized, double-blind, placebo-controlled trial. Minerva Anestesiologica, 88(11), 881–889. https://doi.org/10.23736/S0375-9393.22.16335-2
Lee, I. W.-S., & Schraag, S. (2022). The use of intravenous lidocaine in perioperative medicine: Anaesthetic, analgesic and immune-modulatory aspects. Journal of Clinical Medicine, 11(12), 3543. https://doi.org/10.3390/jcm11123543
Lin, Z., Chen, C., Xie, S., Chen, L., Yao, Y., & Qian, B. (2024). Systemic lidocaine versus erector spinae plane block for improving quality of recovery after laparoscopic cholecystectomy: A randomized controlled trial. Journal of Clinical Anesthesia, 97, 111528.
https://doi.org/10.1016/j.jclinane.2024.111528
Liu, Y., Wang, Y., Gao, Y., Poteat, T., & Matsouaka, R. A. (2025). A tutorial for propensity score weighting methods under violations of the positivity assumption. Statistics in Medicine, 44(28–30), e70329. https://doi.org/10.1002/sim.70329
Lu, J., Wang, J.-F., Guo, C.-L., Yin, Q., Cheng, W., & Qian, B. (2021). Intravenously injected lidocaine or magnesium improves the quality of early recovery after laparoscopic cholecystectomy: A randomised controlled trial. European Journal of Anaesthesiology, 38(Suppl. 1), S1–S8.
https://doi.org/10.1097/EJA.0000000000001348
McEvoy, M. D., Raymond, B. L., & Krige, A. (2022). Opioid-sparing perioperative analgesia within enhanced recovery programs. Anesthesiology Clinics, 40(1), 35–58.
https://doi.org/10.1016/j.anclin.2021.11.001
Meier, I. M., Eikemo, M., Trøstheim, M., Buen, K., Jensen, E., Gurandsrud Karlsen, S., Reme, S. E., Berna, C., Leknes, S., & Ernst, G. (2024). Factors associated with use of opioid rescue medication after surgery. Regional Anesthesia and Pain Medicine, 49(4), 265–271.
https://doi.org/10.1136/rapm-2023-104412
Meneses-Domingo, Y. A., Cadena-Limonchi, J. A., Martínez-Estañol, Á. S., Morales-Contreras, J. A., Baños-González, M. A., & Torres-López, J. E. (2026). Intraoperative haemodynamic responses to opioid-free anaesthesia versus anaesthesia with fentanyl for laparoscopic cholecystectomy: A prospective observational pilot study. BMC Anesthesiology, 26(1).
https://doi.org/10.1186/s12871-026-03688-0
Nip, L., Tong, K.-S., & Borg, C. M. (2022). Three-port versus four-port technique for laparoscopic cholecystectomy: Systematic review and meta-analysis. BJS Open, 6(2), zrac013.
https://doi.org/10.1093/bjsopen/zrac013
Oh, C., Ki, H., Lee, J. Y., Hong, B., & Lim, C. (2026). Impact of multimodal analgesia using intravenous non-opioid agents on immediate postoperative rescue analgesic use following minor general surgery: A retrospective study. The Korean Journal of Pain, 39(3), 421–433.
https://doi.org/10.3344/kjp.26009
Otte, J. A., Chu, G., Heran, B., & Bassett, K. (2025). Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis. Canadian Family Physician, 71(9), 574–581.
https://doi.org/10.46747/cfp.7109574
Paterson, H., Vadiveloo, T., Innes, K., Balfour, A., Atter, M., Stoddart, A., Cotton, S., Arnott, R., Aucott, L., Batham, Z., Foo, I., MacLennan, G., Nimmo, S., Speake, D., & Norrie, J. (2025). Intravenous lidocaine for gut function recovery in colonic surgery: A randomized clinical trial. JAMA, 333(1), 39–48. https://doi.org/10.1001/jama.2024.23898
Pinto, P., Pedraza, J. D., Camacho, D., Fajardo, R., Diaz, F., Avella, C., & Cabrera, L. F. (2023). Retrospective validation of Parkland grading scale in a Latin-American high-volume center. Surgical Endoscopy, 37(7), 5190–5195. https://doi.org/10.1007/s00464-023-09946-3
Qin, J., Gou, L.-Y., Zhang, W., Pu, X., & Zhang, P. (2024). Enhanced recovery after surgery versus conventional care in cholecystectomy: A systematic review and meta-analysis. Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A, 34(8), 710–720.
https://doi.org/10.1089/lap.2024.0119
Sarakatsianou, C., Perivoliotis, K., Baloyiannis, I., Georgopoulou, S., Tsiaka, A., & Tzovaras, G. (2023). Efficacy of intraoperative intravenous lidocaine infusion on postoperative opioid consumption after laparoscopic cholecystectomy: A randomized controlled trial. Langenbeck's Archives of Surgery, 408(1), 197. https://doi.org/10.1007/s00423-023-02937-x
Schneider, T., Mauermann, E., Ilgenstein, B., Jaquiery, C., & Ruppen, W. (2022). Analgesic benefit of metamizole and ibuprofen vs. either medication alone: A randomized clinical trial. Minerva Anestesiologica, 88(6), 448–456. https://doi.org/10.23736/S0375-9393.22.16346-7
Sheikh, H., Zafar, S., Nawaz, K., & Ullah, H. (2025). Comparison of intraoperative intravenous lidocaine infusion and transversus abdominis plane block for postoperative analgesia following laparoscopic cholecystectomy: A randomized controlled trial. Anesthesia and Pain Medicine, 20(3), 266–276. https://doi.org/10.17085/apm.24159
Unalp-Arida, A., & Ruhl, C. E. (2023). Increasing gallstone disease prevalence and associations with gallbladder and biliary tract mortality in the US. Hepatology, 77(6), 1882–1895.
https://doi.org/10.1097/HEP.0000000000000264
Villani, V., Kao, L. S., & Fong, Y. (2026). The difficult cholecystectomy. JAMA Surgery, 161(2), 189–196. https://doi.org/10.1001/jamasurg.2025.4199
Wang, X., Yu, W., Jiang, G., Li, H., Li, S., Xie, L., Bai, X., Cui, P., Chen, Q., Lou, Y., Zou, L., Li, S., Zhou, Z., Zhang, C., Sun, P., & Mao, M. (2024). Global epidemiology of gallstones in the 21st century: A systematic review and meta-analysis. Clinical Gastroenterology and Hepatology, 22(8), 1586–1595. https://doi.org/10.1016/j.cgh.2024.01.051
Alvarez Tiburcio, Z. P., Gonzalez Gomez, K. D., Ordaz Alvarez, H. R., Vargas Basurto, J. L., Perez Morales, A. G., Castellanos Juarez, J. C., Avila Mercado, O., Carrasco Arroniz, M. A., Suarez Alvarez, J. L., Rosario, G. V., Montes Osorio, Z. E., Sempe Minvielle, J., Hernandez Espinoza, R., Cano Contreras, A. D., & Roesch Dietlen, F. B. (2026). Assessment of safety and errors in laparoscopic cholecystectomy in the treatment of gallstone disease in southeastern Mexico. Journal of Clinical Medicine, 15(13), 4869. https://doi.org/10.3390/jcm15134869
Atter, M., Stoddart, A., Cotton, S., Vadiveloo, T., Innes, K., Balfour, A., Arnott, R., Aucott, L., Batham, Z., Foo, I., MacLennan, G., Nimmo, S., Speake, D., Norrie, J., & Paterson, H. (2025). Intravenous lidocaine for gut function recovery in colonic surgery: A health economic evaluation of the ALLEGRO randomised clinical trial. BMJ Open, 15(2), e088298.
https://doi.org/10.1136/bmjopen-2024-088298
Awan, B., Elsaigh, M., Elkomos, B. E., Sohail, A., Asqalan, A., Baqar, S. O. M., Elgendy, N. A., Saleh, O. S., Szul, J. M., Juan, A. S., Alasmar, M., & Marzouk, M. M. (2024). The use of lidocaine infusion in laparoscopic cholecystectomy: An updated systematic review and meta-analysis. Journal of Minimal Access Surgery, 20(3), 239–246. https://doi.org/10.4103/jmas.jmas_265_23
Bourgeois, C., Oyaert, L., Van de Velde, M., Pogatzki-Zahn, E., Freys, S. M., Sauter, A. R., Joshi, G. P., & Dewinter, G. (2024). Pain management after laparoscopic cholecystectomy: A systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations. European Journal of Anaesthesiology, 41(11), 841–855.
https://doi.org/10.1097/EJA.0000000000002047
Dai, Y., Huang, J., & Liu, J. (2024). Effects of intravenous lidocaine on postoperative pain and gastrointestinal function recovery following gastrointestinal surgery: A meta-analysis. Minerva Anestesiologica, 90(6), 561–572. https://doi.org/10.23736/S0375-9393.24.17920-5
Foo, I., Macfarlane, A. J. R., Srivastava, D., Bhaskar, A., Barker, H., Knaggs, R., Eipe, N., & Smith, A. F. (2021). The use of intravenous lidocaine for postoperative pain and recovery: International consensus statement on efficacy and safety. Anaesthesia, 76(2), 238–250.
https://doi.org/10.1111/anae.15270
Foong, K. W., Chaw, S. H., Lo, Y. L., & Loh, P. S. (2024). Population pharmacokinetics of intravenous lidocaine in adults: A systematic review. Clinical Pharmacokinetics, 63(5), 623–643.
https://doi.org/10.1007/s40262-024-01373-4
Freys, S. M., Pogatzki-Zahn, E. M., Rawal, N., & Joshi, G. P. (2025). The role of surgical techniques in reducing postoperative pain in abdominal surgery: Evidence from the PROSPECT systematic reviews. World Journal of Surgery, 49(11), 3081–3089. https://doi.org/10.1002/wjs.70091
Gallaher, J. R., & Charles, A. (2022). Acute cholecystitis: A review. JAMA, 327(10), 965–975.
https://doi.org/10.1001/jama.2022.2350
Hernán, M. A., Wang, W., & Leaf, D. E. (2022). Target trial emulation: A framework for causal inference from observational data. JAMA, 328(24), 2446–2447.
https://doi.org/10.1001/jama.2022.21383
Lapisatepun, W., Nitayamekin, A., Leurcharusamee, P., Pianngarn, I., Maykanggoon, K., Chotirosniramit, A., Junrungsee, S., Sandhu, T., Ko-Iam, W., & Lapisatepun, W. (2022). Efficacy of intravenous versus intraperitoneal lidocaine for postoperative analgesia in laparoscopic cholecystectomy: A randomized, double-blind, placebo-controlled trial. Minerva Anestesiologica, 88(11), 881–889. https://doi.org/10.23736/S0375-9393.22.16335-2
Lee, I. W.-S., & Schraag, S. (2022). The use of intravenous lidocaine in perioperative medicine: Anaesthetic, analgesic and immune-modulatory aspects. Journal of Clinical Medicine, 11(12), 3543. https://doi.org/10.3390/jcm11123543
Lin, Z., Chen, C., Xie, S., Chen, L., Yao, Y., & Qian, B. (2024). Systemic lidocaine versus erector spinae plane block for improving quality of recovery after laparoscopic cholecystectomy: A randomized controlled trial. Journal of Clinical Anesthesia, 97, 111528.
https://doi.org/10.1016/j.jclinane.2024.111528
Liu, Y., Wang, Y., Gao, Y., Poteat, T., & Matsouaka, R. A. (2025). A tutorial for propensity score weighting methods under violations of the positivity assumption. Statistics in Medicine, 44(28–30), e70329. https://doi.org/10.1002/sim.70329
Lu, J., Wang, J.-F., Guo, C.-L., Yin, Q., Cheng, W., & Qian, B. (2021). Intravenously injected lidocaine or magnesium improves the quality of early recovery after laparoscopic cholecystectomy: A randomised controlled trial. European Journal of Anaesthesiology, 38(Suppl. 1), S1–S8.
https://doi.org/10.1097/EJA.0000000000001348
McEvoy, M. D., Raymond, B. L., & Krige, A. (2022). Opioid-sparing perioperative analgesia within enhanced recovery programs. Anesthesiology Clinics, 40(1), 35–58.
https://doi.org/10.1016/j.anclin.2021.11.001
Meier, I. M., Eikemo, M., Trøstheim, M., Buen, K., Jensen, E., Gurandsrud Karlsen, S., Reme, S. E., Berna, C., Leknes, S., & Ernst, G. (2024). Factors associated with use of opioid rescue medication after surgery. Regional Anesthesia and Pain Medicine, 49(4), 265–271.
https://doi.org/10.1136/rapm-2023-104412
Meneses-Domingo, Y. A., Cadena-Limonchi, J. A., Martínez-Estañol, Á. S., Morales-Contreras, J. A., Baños-González, M. A., & Torres-López, J. E. (2026). Intraoperative haemodynamic responses to opioid-free anaesthesia versus anaesthesia with fentanyl for laparoscopic cholecystectomy: A prospective observational pilot study. BMC Anesthesiology, 26(1).
https://doi.org/10.1186/s12871-026-03688-0
Nip, L., Tong, K.-S., & Borg, C. M. (2022). Three-port versus four-port technique for laparoscopic cholecystectomy: Systematic review and meta-analysis. BJS Open, 6(2), zrac013.
https://doi.org/10.1093/bjsopen/zrac013
Oh, C., Ki, H., Lee, J. Y., Hong, B., & Lim, C. (2026). Impact of multimodal analgesia using intravenous non-opioid agents on immediate postoperative rescue analgesic use following minor general surgery: A retrospective study. The Korean Journal of Pain, 39(3), 421–433.
https://doi.org/10.3344/kjp.26009
Otte, J. A., Chu, G., Heran, B., & Bassett, K. (2025). Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis. Canadian Family Physician, 71(9), 574–581.
https://doi.org/10.46747/cfp.7109574
Paterson, H., Vadiveloo, T., Innes, K., Balfour, A., Atter, M., Stoddart, A., Cotton, S., Arnott, R., Aucott, L., Batham, Z., Foo, I., MacLennan, G., Nimmo, S., Speake, D., & Norrie, J. (2025). Intravenous lidocaine for gut function recovery in colonic surgery: A randomized clinical trial. JAMA, 333(1), 39–48. https://doi.org/10.1001/jama.2024.23898
Pinto, P., Pedraza, J. D., Camacho, D., Fajardo, R., Diaz, F., Avella, C., & Cabrera, L. F. (2023). Retrospective validation of Parkland grading scale in a Latin-American high-volume center. Surgical Endoscopy, 37(7), 5190–5195. https://doi.org/10.1007/s00464-023-09946-3
Qin, J., Gou, L.-Y., Zhang, W., Pu, X., & Zhang, P. (2024). Enhanced recovery after surgery versus conventional care in cholecystectomy: A systematic review and meta-analysis. Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A, 34(8), 710–720.
https://doi.org/10.1089/lap.2024.0119
Sarakatsianou, C., Perivoliotis, K., Baloyiannis, I., Georgopoulou, S., Tsiaka, A., & Tzovaras, G. (2023). Efficacy of intraoperative intravenous lidocaine infusion on postoperative opioid consumption after laparoscopic cholecystectomy: A randomized controlled trial. Langenbeck's Archives of Surgery, 408(1), 197. https://doi.org/10.1007/s00423-023-02937-x
Schneider, T., Mauermann, E., Ilgenstein, B., Jaquiery, C., & Ruppen, W. (2022). Analgesic benefit of metamizole and ibuprofen vs. either medication alone: A randomized clinical trial. Minerva Anestesiologica, 88(6), 448–456. https://doi.org/10.23736/S0375-9393.22.16346-7
Sheikh, H., Zafar, S., Nawaz, K., & Ullah, H. (2025). Comparison of intraoperative intravenous lidocaine infusion and transversus abdominis plane block for postoperative analgesia following laparoscopic cholecystectomy: A randomized controlled trial. Anesthesia and Pain Medicine, 20(3), 266–276. https://doi.org/10.17085/apm.24159
Unalp-Arida, A., & Ruhl, C. E. (2023). Increasing gallstone disease prevalence and associations with gallbladder and biliary tract mortality in the US. Hepatology, 77(6), 1882–1895.
https://doi.org/10.1097/HEP.0000000000000264
Villani, V., Kao, L. S., & Fong, Y. (2026). The difficult cholecystectomy. JAMA Surgery, 161(2), 189–196. https://doi.org/10.1001/jamasurg.2025.4199
Wang, X., Yu, W., Jiang, G., Li, H., Li, S., Xie, L., Bai, X., Cui, P., Chen, Q., Lou, Y., Zou, L., Li, S., Zhou, Z., Zhang, C., Sun, P., & Mao, M. (2024). Global epidemiology of gallstones in the 21st century: A systematic review and meta-analysis. Clinical Gastroenterology and Hepatology, 22(8), 1586–1595. https://doi.org/10.1016/j.cgh.2024.01.051
Publicado
2026-11-04
Cómo citar
Vázquez Jiménez , M. de J., Sánchez Hernández, L. K., Guadalupe Garrido Pérez, S. M., Muñoz Camacho, J. M., Contreras Pérez, E., & Zapata Vázquez, R. (2026). Efecto Analgésico Postoperatorio de la Lidocaína Transoperatoria en Colecistectomía Laparoscópica. Ciencia Latina Revista Científica Multidisciplinar, 10(5), 6120-6145. https://doi.org/10.37811/cl_rcm.v10i5.26453
Número
Sección
Ciencias de la Salud
Derechos de autor 2026 Manuel de Jesús Vázquez Jiménez , Leslie Krystel Sánchez Hernández, Silvia María Guadalupe Garrido Pérez, Jesús Mauricio Muñoz Camacho, Eduardo Contreras Pérez, Rosario Zapata Vázquez
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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