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Abstract
Objectives: To compare costs, health outcomes and cost-effectiveness of using intravenous (IV) lidocaine (bolus given at induction of anaesthesia, followed by infusion for 6-12 hours) during colorectal surgery to improve the return of gastrointestinal function.
Design: Within-trial planned analysis of data from a randomised controlled trial (RCT) using an intention-to-treat approach.
Setting: 27 hospitals from across the UK.
Participants: 557 patients aged 25-91 having minimally invasive elective colorectal resection.
Intervention: A 1:1 randomisation between IV lidocaine and placebo, minimised for age (<50 years, 50-74 years, ≥75 years), gender, and trial centre.
Primary outcome measures: Mean differences between trial arms in 30-day and 90-day quality-adjusted life years (QALYs) and 30-day total NHS costs, as well as the 30-day Incremental Cost-Effectiveness Ratio (ICER).
Results: Compliance and data quality were high. IV lidocaine is associated with differences of £38 (95% CI: -£463, £589) in total 30-day costs, 0.0005 (95% CI: -0.0028, 0.0014) in 30-day QALYs, and 0.0008 (95% CI: -0.0066, 0.0048) in 90-day QALYs. No large, statistically significant, or meaningful differences in primary or secondary outcome measures between trial arms were detected, other than for the intervention costs.
Conclusion: IV lidocaine is not found to impact costs or health outcomes for patients undergoing colorectal surgery. In the absence of a clinical effect, disinvestment from perioperative lidocaine could save costs associated with infusion monitoring.
Design: Within-trial planned analysis of data from a randomised controlled trial (RCT) using an intention-to-treat approach.
Setting: 27 hospitals from across the UK.
Participants: 557 patients aged 25-91 having minimally invasive elective colorectal resection.
Intervention: A 1:1 randomisation between IV lidocaine and placebo, minimised for age (<50 years, 50-74 years, ≥75 years), gender, and trial centre.
Primary outcome measures: Mean differences between trial arms in 30-day and 90-day quality-adjusted life years (QALYs) and 30-day total NHS costs, as well as the 30-day Incremental Cost-Effectiveness Ratio (ICER).
Results: Compliance and data quality were high. IV lidocaine is associated with differences of £38 (95% CI: -£463, £589) in total 30-day costs, 0.0005 (95% CI: -0.0028, 0.0014) in 30-day QALYs, and 0.0008 (95% CI: -0.0066, 0.0048) in 90-day QALYs. No large, statistically significant, or meaningful differences in primary or secondary outcome measures between trial arms were detected, other than for the intervention costs.
Conclusion: IV lidocaine is not found to impact costs or health outcomes for patients undergoing colorectal surgery. In the absence of a clinical effect, disinvestment from perioperative lidocaine could save costs associated with infusion monitoring.
| Original language | English |
|---|---|
| Article number | e088298 |
| Number of pages | 11 |
| Journal | British Medical Journal (BMJ) |
| Volume | 15 |
| DOIs | |
| Publication status | Published - 25 Feb 2025 |
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Dive into the research topics of 'Intravenous Lidocaine for Gut Function Recovery in Colonic Surgery: A Health Economic Evaluation of the ALLEGRO Randomised Clinical Trial'. Together they form a unique fingerprint.Projects
- 1 Finished
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A Placebo Controlled Randomised Trial Of Intravenous Lidocaine In Accelerating Gastrointestinal Recovery After Colorectal Surgery
Paterson, H. (Principal Investigator) & Hall, P. (Co-investigator)
1/06/17 → 31/05/22
Project: Research