Perioperative Intravenous Lidocaine Infusion for Patients Undergoing Laparoscopic and Open Pancreatectomies

Inclusion Criteria:

- All adult patients undergoing elective open or laparoscopic total pancreatectomies and
pancreatoduodenectomies (i.e., Whipple procedure), and participating in the Enhanced
Recovery Protocol (ERP) at Mayo Clinic in Florida.

- Age 18 - 80 years old

- American Society of Anesthesiologist (ASA) class I - III

- BMI < 40

- Ability to understand and read English

Exclusion Criteria:

- Not able or willing to sign consent

- Intolerance or allergy to opioids, NSAIDS, acetaminophen, or amide-type local
anesthetics (i.e., lidocaine).

- History of epilepsy or currently receiving treatment for seizures

- Severe hepatic insufficiency (Child-Pugh Score C)

- Renal insufficiency (creatinine clearance less than 30 mL/minute)

- Advance heart failure (NY Heart failure stage 3 or greater; Ejection function <30%)

- Cardiac arrhythmias: 2nd and 3rd degree heart block, sick sinus syndrome, symptomatic
bradyarrhythmias, Wolff-Parkinson-White (WPW) syndrome, or Stokes-Adams syndrome; Left
bundle branch block or bifascicular block; Not to exclude patients the following
conditions unless clinical circumstance dictate: Atrial fibrillation or atrial
fluTter; Presence of Implantable Cardioverter Defibrillator (ICD), or pacemakers

- Patients on anti-arrhythmic therapy (i.e., digoxin, amiodarone, flecainide, lidocaine,
sotalol, etc.). Not to exclude patients on beta blockers (i.e., metoprolol, atenolol,
etc.) unless clinical circumstance dictate

- Patients with active psychiatric disorders or cognitive dysfunction

- Pregnancy or lactating

- Enucleation, central, and distal pancreatectomy

- Opioid tolerance (defined as consumption of greater than 30 mg of oxycodone per day)