EP628 - Effect of Perioperative Intravenous Lidocaine on Colorectal Cancer Metastasis

Monday, May 12, 2025

8:27 AM – 8:32 AM PT

Location: Monitor 4, Sails Pavilion, Upper Level

ePoster Presenter(s)

PM

Peyton M. Murdock, MD

General Surgery Resident
University of Tennessee Medical Center Knoxville
Knoxville, TN, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

AR

Andrew J. Russ, MD FACS FASCRS, MD

Professor Program Director, General Surgery Residency Chief, Division of Colorectal Surgery
University of Tennessee Graduate School of Medicine
Knoxville, Tennessee, United States

Disclosure information not submitted.
LM

Lillian McCampbell, BS

Medical Student
UTHSC
Knoxville, Tennessee, United States

Disclosure information not submitted.
TH

Trey Henderson, MSc

Research Coordinator
The University of Tennessee Department of Anesthesiology
Knoxville, Tennessee, United States

Disclosure information not submitted.
JM

James McLoughlin, MD, MBA

Professor of Surgery
University of TN Medical Center - Knoxville
Knoxville, Tennessee, United States

Disclosure information not submitted.

Senior Author(s)

JB

Jason Buehler, MD

Associate Professor
University of Tennessee
Knoxville, Tennessee, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Peyton M. Murdock, MD: This individual has no financial relationships with ineligible companies.

Jason Buehler, MD: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Over 150,000 people are diagnosed with colorectal cancer annually. Surgery remains a mainstay in the treatment algorithm. The perioperative period increases stress, and this inflammatory process is theorized to promote metastasis. Intravenous lidocaine (IV-L) is a local anesthetic which has shown some promise in its effects on cancer by triggering apoptosis and inhibiting proliferation and invasion of cancer cells. We evaluated the impact of IV-L use on colorectal cancer outcomes.

Methods/Interventions: We evaluated 156 patients (89 female, 67 male) who underwent colectomies for colorectal cancer at a single academic institution from 2018 through 2021. Patients were randomized to receive (n = 110, 70.5%) or not receive (n = 46, 29.5%) a continuous IV-L infusion for up to 48 hours perioperatively. Variables evaluated were age, gender, race, BMI, ASA classification, estimated blood loss, intraoperative IV fluid volume, duration of anesthesia, operative time, hospital length of stay, and tumor stage and grade. The primary outcome studied was the rate of cancer recurrence through April 2024.

Results/Outcomes: Of 156 patients, a total of 14 developed metastatic recurrence with 10 in the group that received IV-L (9%) and four in the group that did not receive IV-L (8.7%). There were 12 patients who died with nine in the IV-L group (8.2%) and three in the no IV-L group (6.5%). A multi-variate logistic regression model was performed to evaluate intraoperative IV-L, age, BMI, ASA classification, operative time, estimated blood loss, tumor stage and grade and the influence on the rate of distant recurrence. None of these variables were proved to be statistically significant.

Conclusion/Discussion: IV-L is a useful adjunct to manage pain in the perioperative period for colorectal cancer surgery. Our results, however, suggest that the use of continuous intraoperative IV-L does not contribute to a reduction in the rate of metastasis in colorectal cancer. The anti-inflammatory effects are either inadequate to prevent metastases or the exposure too limited to be impactful. Further studies, ideally randomized controlled trials, are needed to determine if IV-L has a contributory role in reducing colorectal cancer metastasis.