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HepatectomyPhase 4ILHEPNCT07590830

Intravenous Lidocaine for Hepatectomy

A Phase 4 study testing Standardized General Anesthesia Induction and Maintenance Protocol incorporating Intravenous Lidocaine in people with Hepatectomy, run by Rennes University Hospital at 9 sites in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

Liver resection is increasingly performed for hepatic tumors, mainly primary liver cancers and resectable metastases, but also for some benign lesions. Postoperative pain is often significant, regardless of the surgical technique, making effective pain control essential to promote early mobilization and reduce… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hepatectomy
What is being tested?
Standardized General Anesthesia Induction and Maintenance Protocol incorporating Intravenous Lidocaine
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
312 participants
Where
9 sitesFrance
Study dates
1 Aug 2026to 1 Sep 2028
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Inclusion criterion 2 : Undergoing a scheduled surgery for open hepatectomy
  • Inclusion criterion 3 : Effective contraception in accordance with CFTG recommendations
  • Inclusion criterion 4 : Having received oral and written information about the protocol and having signed a consent form to take part in this research
  • Inclusion criterion 5 : Affiliated to a social security scheme

Who cannot join

  • Exclusion criterion 2 : Allergy or contraindication to lidocaine or one of its excipients and, in particular:
  • Known hypersensitivity to lidocaine hydrochloride, to amide-type local anesthetics, or to any of the excipients (sodium chloride, sodium hydroxide solution or concentrated hydrochloric acid solution, water for injection)
  • Treatment with following antiarythmic medication : class I, class III or Sotalol
  • Heart failure NYHA grade 3-4, AV-block >1, without pacemaker
  • Acute porphyria
  • Recurrent porphyrias
Show all 24Show fewer
  • Uncontrolled epilepsy / Seizure at enrollment
  • Exclusion criterion 3 : Allergy to one of the drugs used for anaesthesia or one of their excipients
  • Exclusion criterion 4 : Nefopam contraindication and, in particular:
  • Renal insufficiency (Creatinine clearance < 15 mL/min)
  • Untreated glaucoma
  • Uncontrolled epilepsy
  • Allergy
  • Exclusion criterion 5 : Ketoprofen contraindication and, in particular:
  • Renal insufficiency (Creatinine clearance < 50 mL/min)
  • Inflammatory bowel disease
  • Allergy
  • Exclusion criterion 7 : Transplant surgery or transplanted patients
  • Exclusion criterion 8 : Surgery with planned regional anaesthesia
  • Exclusion criterion 9 : Patient with a preoperative Sp02 < 95%
  • Exclusion criterion 11 : Severe hepatic insufficiency (Prothrombin Ratio < 15%)
  • Exclusion criterion 12 : Patient with an ongoing opioid medication that will blur the results
  • Exclusion criterion 13 : Adults under legal protection (safeguard of justice, curatorship, guardianship), persons deprived of their liberty, pregnant or breast-feeding women, minors, persons unable to express their consent, persons hospitalized for a different reason
  • Exclusion criterion 14 : Known participation in other interventional research (RIPH1 or RIPH2)

Trial locations and contacts

9 sites in 1 country. Contact the study team or a site near you to ask about taking part.

9 sites in 1 country

France9 sites
  • Centre 03 - CHU de Clermont-Ferrand, Hôpital Estaing

    Clermont-Ferrand, 63100

    Ugo SCHIFF, MD, +33473755168, uschiff@chu-clermontferrand.fr

    Ugo SCHIFF, MD

  • Centre 04 - Centre Hospitalier Départemental de la Vendée

    La Roche-sur-Yon, 85000

    Alexis DUCHALAIS, MD, +33251446237, alexis.duchalais@ght85.fr

    Alexis DUCHALAIS, MD

  • Centre 02 - CH Louis Pasteur, Les Hôpitaux de Chartres

    Le Coudray, 28630

    Nidhal CHEBBI, MD, +33237303030, nchebbi@ch-chartres.fr

    Nidhal CHEBBI, MD

  • Centre 05 - CHU de Lille

    Lille, 59000

    Gilles LEBUFFE, MD, +330320444508, gilles.lebuffe@chru-lille.fr

    Gilles LEBUFFE, MD

  • Centre 06 - Centre Léon Bérard

    Lyon, 69008

    Grégoire WALLON, MD, +33478782971, gregoire.wallon@lyon.unicancer.fr

    Grégoire WALLON, MD

  • Centre 07 - CHU Nice, Hôpital Archet 2

    Nice, 06200

    Romain ROZIER, MD, +33492036647, rozier.r@chu-nice.fr

    Romain ROZIER, MD

  • Centre 08 - AP-HP - Sorbonne Université, Hôpital de la Pitié-Salpêtrière

    Paris, 75013

    Alexandre SITBON, MD, +33184827379, alexandre.sitbon@aphp.fr

    Alexandre SITBON, MD

  • Centre 01 - CHU de RENNES, Hôpital Pontchaillou

    Rennes, 35000

    Pr Hélène BELOEIL, MD, +33299282422, helene.beloeil@chu-rennes.fr

    Pr Hélène BELOEIL, MD

  • Centre 09 - CHU Toulouse, Hôpital Rangueil

    Toulouse, 31400

    Guillaume PORTA BONETE, MD, +33561323565, porta-bonete.g@chu-toulouse.fr

    Guillaume PORTA BONETE, MD

Other trials in France

About this study

Official title: Effect of Perioperative Intravenous Lidocaine on Postoperative Opioid Related-side Effects After Open HEPatectomy: a Multicentre Prospective Randomized Controlled Study

Liver resection is increasingly performed for hepatic tumors, mainly primary liver cancers and resectable metastases, but also for some benign lesions. Postoperative pain is often significant, regardless of the surgical technique, making effective pain control essential to promote early mobilization and reduce complications.

Current standard care relies on multimodal analgesia, combining several drugs administered during surgery, with morphine administered as rescue therapy when required. Morphine is associated with side effects such as nausea, vomiting, ileus, hypoxemia, opioid-induced hyperalgesia, and transient cognitive impairment. Therefore, there is a need to optimize pain management while reducing opioid consumption and related adverse effects.

Read more

Intravenous (IV) lidocaine has well-documented anti-inflammatory effects and is effective against neuropathic pain. Several studies have shown that intravenous lidocaine may be associated with improved analgesia, reduced opioid consumption, shorter hospital stay, and decreased postoperative ileus, nausea, and vomiting-particularly in abdominal and genitourinary surgeries. Therefore, Intravenous (IV) lidocaine may be a valuable alternative for postoperative pain management after liver surgery.

National guidelines now recommend perioperative Intravenous (IV) lidocaine for abdominal surgeries but its efficacy in liver surgery has not yet been established due to a lack of specific evidence (more specific data are needed). Findings from other types of abdominal surgery suggest a potential benefit, which should be confirmed by dedicated clinical trials and robust multicenter evaluation such as the ILHEP protocol.

The goal of this clinical trial is to assess the effect of intravenous perioperative lidocaine on postoperative opioid related-side effects and to formally confirm the safety of lidocaine during hepatic surgical procedures. The hypothesis is that Intravenous (IV) lidocaine compared with placebo (a look-alike substance that contains no drug e.g. a saline solution) would improve postoperative outcome by reducing opioid related side-effects in patients undergoing liver surgery and benefitting of the same baseline analgesia.

In the context of this trial, patients will receive either intravenous lidocaine or placebo according to their assigned randomization group during standardized general anesthesia, and will then be followed throughout their hospital stay until discharge or up to a maximum of 28 days.

An ancillary study will be conducted in patients enrolled at the coordinating center in Rennes to assess exposure to lidocaine during intravenous administration and to evaluate the relationship between blood concentrations and adverse events.

Read the detailed description

Patients scheduled for surgery under general anesthesia meeting the inclusion criteria will be eligible. During the preoperative anesthesia consultation (from Day-30 to Day-1), the investigator will present the study and the objectives of the research to the patient. When the patient arrives for admission, on the same day as the experimental visit or the day before (from Day-1 or Day 0), the investigator will verify the inclusion criteria and collect the written informed consent. Once inclusion has been validated, data will be collected : Socio-demographic data / Clinical data / List of chronic medications prior to surgery.

After signing the consent form and before the first dose of medication is taken, participants will be randomized into the control (placebo) or experimental group (lidocaine). In order to ensure group compatibility, a plan of randomization will be used : patients will be assigned to the treatment group in chronological order of randomization numbers, using a centralized randomization method via Ennov software (Ennov Clinical, Groupe Ennov, Paris, France). Randomization will be carried out online by investigators as close as possible to the surgery (Day-1 or Day 0). Participants and investigators will be blinded to the intervention.

Regarding the surgical procedure, general anesthesia will be standardized, and patients will receive either placebo or lidocaine according to the group to which they were assigned during randomization.

Physicians will be warned to reinject sufentanil or remifentanil during surgery in an opioid sparing spirit.

The postoperative protocol will be standardized. Extubation defines the Hour 0 for assessment of the primary criterion events. Aside from the placebo or lidocaine administered according to their randomization group, all patients will receive standard postoperative treatment.

An ancillary study will be conducted at the coordinating centre and is expected to include approximately 20 patients to assess drug exposure during perioperative intravenous lidocaine administration. It will also evaluate the relationship between maximal total and free concentrations (Cmax and Cmaxμ, measured at the end of the intravenous lidocaine bolus) and/or steady-state concentrations (Css and Cssμ, measured at the end of lidocaine administration) and the occurrence of adverse events. Blood samples (5 mL) will be drawn through a catheter:

  • 5 minutes after the lidocaine or placebo bolus
  • at the end of the lidocaine or placebo administration in post anesthesia care unit (PACU)

This trial is an intention to treat study, that is all randomized patients will be analyzed in their randomization group.

Conditions
Hepatectomy
Being tested
Standardized General Anesthesia Induction and Maintenance Protocol incorporating Intravenous Lidocaine, Standardized General Anesthesia Induction and Maintenance Protocol incorporating Placebo
Keywords
Lidocaine, Pain management, Analgesics, Postoperative opioid related-side effects, Double-Blind Method, Hepatectomy, Anesthesia
Medical subject headings
Agnosia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Standardized General Anesthesia Induction and Maintenance Protocol incorporating Intravenous LidocaineDrug

    Also called Lidocaine

    Standard general anaesthesia induction protocol with pre-defined bolus of lidocaine and standard general anaesthesia maintenance protocol with pre-defined continuous intravenous infusion of lidocaine

  • Standardized General Anesthesia Induction and Maintenance Protocol incorporating PlaceboDrug

    Also called Placebo

    Standard general anaesthesia induction protocol with pre-defined bolus of placebo and standard general anaesthesia maintenance protocol with pre-defined continuous intravenous infusion of placebo

Study groups in NCT07590830
Study groupRoleWhat they receive
Lidocaine GroupExperimentalStandard anaesthesia protocol with lidocaine
Receives: Drug: Standardized General Anesthesia Induction and Maintenance Protocol incorporating Intravenous Lidocaine
Control GroupPlacebo comparatorStandard anaesthesia protocol with placebo (NaCl)
Receives: Drug: Standardized General Anesthesia Induction and Maintenance Protocol incorporating Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. To compare the effects of a perioperative lidocaine infusion versus placebo on the composite incidence of postoperative opioid-related adverse events, assessed blinded to the randomization group, in patients undergoing open hepatectomy.

    Number of participants with at least one of the following postoperative opioid-related adverse events : Postoperative nausea and vomiting defined as any nausea or vomiting ; Postoperative hypoxemia defined as SpO2 < 95% with a need for oxygen supplementation ; Postoperative ileus duration. Ileus is defined as an intolerance to an oral diet (e.g. soft food or light meal)

    Measured: from Hour 0 (extubation) to Hour 48

Secondary outcomes (22)
  1. Determine the occurrence of postoperative opioid-related nausea and vomiting

    Occurrence of postoperative opioid-related nausea and vomiting (the need for anti-emetic medication will also be recorded)

    Measured: from Hour 0 to Hour 48

  2. Determine the occurrence of postoperative opioid-related hypoxemia

    Occurrence of postoperative opioid-related hypoxemia (duration of oxygen treatment will also be recorded)

    Measured: from Hour 0 to Hour 48

  3. Determine the occurrence of postoperative opioid-related ileus

    Occurrence of postoperative opioid-related ileus

    Measured: from Hour 0 to Hour 48

  4. Determine the occurrence of postoperative opioid-related absence of flatus or stools

    Occurrence of postoperative opioid-related absence of flatus or stools

    Measured: from Hour 0 to Hour 48

  5. Determine if lidocaine is associated with a better postoperative analgesia at rest, as measured by the number of episodes with a Numeric Rating Scale score > 3, recorded every 10 minutes during post anesthesia care unit stay and every 6 hours thereafter.

    Number of episodes with Numeric Rating Scale score > 3 at rest Numeric rating scale : Zero is equivalent to no pain and 10 indicates the worst possible pain.

    Measured: from Hour 0 to Hour 48

  6. Determine if lidocaine is associated with a better postoperative analgesia at rest, as measured by the maximum Numeric Rating Scale score recorded.

    Maximum Numeric rating scale score recorded at rest Numeric rating scale : Zero is equivalent to no pain and 10 indicates the worst possible pain.

    Measured: from Hour 0 to Hour 48

  7. Determine if lidocaine is associated with a better postoperative analgesia during movement, as measured by the number of episodes with a NRS score > 3, recorded every 10 minutes during Post-Anesthesia Care Unit stay and every 6 hours thereafter

    Number of episodes with Numeric rating scale > 3 during movement Numeric rating scale : Zero is equivalent to no pain and 10 indicates the worst possible pain.

    Measured: from Hour 0 to Hour 48

  8. Determine if lidocaine is associated with a better postoperative analgesia during movement, as measured by the maximum Numeric Rating Scale score recorded.

    Maximum Numeric rating scale score recorded during movement Numeric rating scale : Zero is equivalent to no pain and 10 indicates the worst possible pain.

    Measured: from Hour 0 to Hour 48

  9. Determine if lidocaine can reduce postoperative opioid consumption

    Opioid consumption (mg)

    Measured: from Hour 0 to Hour 48

  10. Determine if lidocaine can reduce the delay to obtain an Aldrete score ≥ 9 after extubation

    Time (minutes) between extubation (H0) and achieving an Aldrete score ≥ 9 Aldrete Scoring System consists of 5 clinically relevant parameters reflecting physiological recovery from anesthesia (muscle activity, respiration, circulation, consciousness, and color) ranging from 0 (no recovery) to 10 (full recovery).

    A total score of 0 indicates no recovery across the assessed criteria and reflects the poorest possible post-anesthesia status. A total score of 10 indicates full recovery across all assessed criteria, represents the best possible post-anesthesia status and is generally ready for discharge from the post-anesthesia care unit.

    Measured: from Hour 0 (extubation) to Post-Anesthesia Care Unit discharge, up to 24 hours

  11. Determine if lidocaine reduces postoperative rate of unscheduled admission in intensive care unit (ICU)

    Rate of unscheduled admission in intensive care unit

    Measured: from Hour 0 to Day 28

  12. Determine if lidocaine reduces the length of stay in the hospital

    Hospital length of stay (minutes)

    Measured: from Hour 0 to Day 28

  13. Determine if lidocaine reduces the incidence of the most frequent complications, particularly pneumonia

    Occurrence of pneumonia episodes of newly confirmed pneumonia according to the modified Centers for Disease Control and Prevention (CDC) criteria.

    Measured: from Hour 0 to Day 7 or until hospital discharge, whichever occurs first; maximum Day 28

  14. Determine if lidocaine reduces the incidence of the most frequent complications, particularly acute kidney injury

    Occurrence of acute kidney insufficiency defined with Kidney Disease Improving Global Outcomes (KDIGO) ≥ 2

    Measured: from Hour 0 to Day 7 or until hospital discharge, whichever occurs first; maximum Day 28

  15. Determine if lidocaine reduces the incidence of the most frequent complications, particularly the need for reintervention because of a surgical complication

    Occurrence of reintervention because of surgical complication

    Measured: from Hour 0 to Day 7 or until hospital discharge, whichever occurs first; maximum Day 28

  16. Determine if lidocaine reduces the incidence of the most frequent complications, particularly new onset of postoperative atrial fibrillation

    Occurrence of a new onset of postoperative atrial fibrillation

    Measured: from Hour 0 to Day 7 or until hospital discharge, whichever occurs first; maximum Day 28

  17. Determine if lidocaine is associated with a better quality of recovery

    Quality of recovery questionnaire QoR-40 is a 40-item questionnaire used to assess postoperative quality of recovery : the total score ranges from 40 (the worst possible recovery) to 200 (the best possible recovery).

    Measured: from Hour 24 to Hour 48

  18. Monitore the adverse effects of intravenous lidocaine

    Number of adverse effects of intravenous experimental treatment

    Measured: from Hour 0 to Hour 24

  19. Evaluate drug exposure in 20 patients included in the coordinating center : relationship between maximal total plasma lidocaine concentration and the occurrence of adverse events

    Maximal total plasma lidocaine concentrations : Cmax , measured 5 minutes after the end of the IV lidocaine bolus

    Measured: Perioperative/Periprocedural (5 minutes after the end of the IV lidocaine bolus)

  20. Evaluate drug exposure in 20 patients included in the coordinating center : relationship between maximal free plasma lidocaine concentration and the occurrence of adverse events

    Maximal free plasma lidocaine concentrations : Cmaxμ, measured 5 minutes after the end of the IV lidocaine bolus

    Measured: Perioperative/Periprocedural (5 minutes after the end of the IV lidocaine bolus)

  21. Evaluate drug exposure in 20 patients included in the coordinating center : relationship between steady-state total plasma lidocaine concentration and the occurrence of adverse events

    Steady-state total plasma lidocaine concentration : Css, measured at the end of IV continuous lidocaine administration

    Measured: Day 0 (at the end of IV continuous lidocaine administration)

  22. Evaluate drug exposure in 20 patients included in the coordinating center : relationship between steady-state free plasma lidocaine concentration and the occurrence of adverse events

    Steady-state free plasma lidocaine concentration : Cssµ, measured at the end of IV continuous lidocaine administration

    Measured: Day 0 (at the end of IV continuous lidocaine administration)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 May 2026
  2. Study start1 Aug 2026 (estimated)
  3. Primary completion1 Sep 2028 (estimated)
  4. Study completion1 Sep 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
The ILHEP study is a multicenter, prospective, randomized, controlled double-blind study
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
312 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07590830
Sponsor's protocol ID
35RC23_8878_ILHEP
Other IDs
2025-522462-73-00, 2025
Acronym
ILHEP
Status last verified
May 2026
First submitted
22 Apr 2026
Last updated
15 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Standardized General Anesthesia Induction and Maintenance Protocol incorporating Intravenous Lidocaine in people with Hepatectomy, run by Rennes University Hospital at 9 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 15 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Pr Hélène BELOEIL, MD (+33299282422, helene.beloeil@chu-rennes.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To compare the effects of a perioperative lidocaine infusion versus placebo on the composite incidence of postoperative opioid-related adverse events, assessed blinded to the randomization group, in patients undergoing open hepatectomy. (time frame: from Hour 0 (extubation) to Hour 48). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 May 2026.

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