• Anesthesia and analgesia · May 1961

    Xylocaine for the relief of postoperative pain.

    Bartlett and Hutaserani published the first description of the intravenous use of lignocaine for postoperative pain management in 1961.

    "THE SEARCH for a nondepressant, long-acting drug to control postoperative pain has gone on for many years. Like many other institutions, ours has run the gamut of drugs as they have been released: nupercaine-in-oil, intravenous procaine, efocaine, intravenous alcohol, d-tubocurarine-in-oil, etc. All have had their drawbacks."
    

    The researchers investigated a progressive range of administration routes and dosages, ultimately reaching 1000 mg lignocaine in 1L IVF given over the duration of surgery. 302 patients receiving intravenous lignocaine were compared to matched controls, finding:

    "...during the first 3 postoperative days 83 per cent of the patients who received Xylocaine experienced either no pain or 1+ pain (soreness only) as contrasted with 25 per cent of the controls."
    

    Intravenous lignocaine also dramatically reduced post-operative opioid consumption.

    Another group (N=60) received 500 mg lignocaine into the rectus muscles after laparotomy, improving no-pain or 1+ pain incidence to 95%.

    summary
    • E E BARTLETT and O HUTSERANI.
    • Anesth. Analg. 1961 May 1;40:296-304.

    no abstract available

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    This article appears in the collections: Lignocaine and Does intravenous lidocaine/lignocaine improve post-operative recovery?.

    Notes

    summary
    1

    Bartlett and Hutaserani published the first description of the intravenous use of lignocaine for postoperative pain management in 1961.

    "THE SEARCH for a nondepressant, long-acting drug to control postoperative pain has gone on for many years. Like many other institutions, ours has run the gamut of drugs as they have been released: nupercaine-in-oil, intravenous procaine, efocaine, intravenous alcohol, d-tubocurarine-in-oil, etc. All have had their drawbacks."
    

    The researchers investigated a progressive range of administration routes and dosages, ultimately reaching 1000 mg lignocaine in 1L IVF given over the duration of surgery. 302 patients receiving intravenous lignocaine were compared to matched controls, finding:

    "...during the first 3 postoperative days 83 per cent of the patients who received Xylocaine experienced either no pain or 1+ pain (soreness only) as contrasted with 25 per cent of the controls."
    

    Intravenous lignocaine also dramatically reduced post-operative opioid consumption.

    Another group (N=60) received 500 mg lignocaine into the rectus muscles after laparotomy, improving no-pain or 1+ pain incidence to 95%.

    Daniel Jolley  Daniel Jolley
    comment
    0

    A fascinating historical article, both because of it's current relevance and the glimpse it provides of the exploration of a relatively new drug – along with tidbits regarding the safety of the technique:

    "This is borne out by the fact that after many thousands of cases had been done, the first case of convulsions occurred. The intravenous Xylocaine had been increased to a very rapid rate and generalized convulsions ensued. For this case, all that was needed, was to stop the drip, supplement respiration with 100% oxygen and wait several minutes for the convulsion to subside. Thiopental sodium and succinylcholine chloride were at hand but not needed. However, it should be emphasized that this technique is not for the beginner."

    Daniel Jolley  Daniel Jolley
     
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