Clinical Research Directory

Inclusion Criteria: * Patients aged 18+ years of age * American Association of Anesthesiologists (ASA) scores of I-III * Undergoing elective laparoscopic paraesophageal hernia repair including robotic assisted laparoscopic cases. * All paraesophageal hernia patients seen in clinic who meet inclusion criteria will be given the option to enroll. * Cases converted to open laparotomy or hand-assisted laparoscopy will be included for intention to treat analysis. * Patients who have complications of Clavien-Dindo class 3 or greater will be included in calculations of complication rates. However, they will not be included in calculations of postoperative morphine equivalents, as repeat intervention will confound the normal course of postoperative pain control. Exclusion Criteria: * Patients with end stage renal disease * Patients with allergies to lidocaine and other amide local anesthetics. * Patients with contraindications to sodium channel blockers. * Patients with psychomotor retardation * Patients with body mass index \>40 mg/kg2. * Patients receiving opioid pain medication in the previous week or taking daily medication for chronic pain * Patients with a seizure disorder * Patients with cardiac intraventricular conduction delays, congestive heart failure, first and second-degree heart conduction blocks. * Patients undergoing planned concomitant procedures other than PEH repair * Patients that are classified as ASA 4 or 5 during pre-operative anesthesia visit (if needed) will be excluded. Documentation from the pre-op visit will be reviewed by the research team prior to the surgery date. * Exclusion from all or portions will be at the discretion of the attending surgeon and anesthesiologist.