BACKGROUND: Postoperative ileus and pain are concerns among surgical patients. Epidural anesthesia and analgesia with local anesthetics can decrease the duration of postoperative ileus and pain. Significant systemic absorption of local anesthetics occurs during epidural use. The object of the study was to define the effect of intravenous (iv) lidocaine on postoperative ileus and pain. METHODS: In a double-blind prospective study, 24 patients undergoing foot surgery were studied with one half of the patients receiving a lidocaine bolus (1.5 mg/kg) and infusion (2 mg/min) (n=12 Lidocaine group); the other half received a saline infusion (n=12 Control group). IV lidocaine initiated before general anesthesia and continued 1h postoperatively. We compared faces pain rating scale (at recovery room, op. day 7 PM, postop. 1 day 7 PM, postop. 2 day 7 PM), the total amount of analgesic use, the return of bowel function (first passage of flatus), hospital stay, side effects, patient satisfaction. RESULT: Perioperative IV lidocaine infusion reduced the pain scale at recovery room, op.day 7 PM, postop. 1 day 7 PM but not postop. 2 day 7 PM. No significant difference was found in return of bowel function, additional analgesics use, hospital stay, subjective satisfaction between 2 groups. No specific side effect due to lidocaine was found. CONCLUSION: IV lidocaine-treated patients has less pain postoperatively, but no faster return of bowel function in patients undergoing foot surgery.