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Created September 16, 2015, last updated over 3 years ago.
Collection: 55, Score: 2156, Trend score: 0, Read count: 2419, Articles count: 63, Created: 2015-09-16 12:50:47 UTC. Updated: 2021-02-08 00:12:08 UTC.Notes
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Collected Articles
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Anesthesia and analgesia · Aug 2012
Randomized Controlled TrialSystemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery.
Intraoperative intravenous lidocaine improves the quality of recovery following ambulatory laparoscopic surgery.
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Randomized Controlled Trial
Perioperative intravenous lidocaine decreases the incidence of persistent pain after breast surgery.
Perioperative lidocaine (1.5 mg/kg bolus then 1.5 mg/kg/h until 1 h after skin closure) reduces the incidence of persistent post-surgical pain after breast cancer surgery at 3 months.
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Randomized Controlled Trial
Effect of Perioperative Intravenous Lidocaine Administration on Pain, Opioid Consumption, and Quality of Life after Complex Spine Surgery.
The authors tested the primary hypothesis that perioperative IV lidocaine administration during spine surgery (and in the postanesthesia care unit for no more than 8 h) decreases pain and/or opioid requirements in the initial 48 postoperative hours. Secondary outcomes included major complications, postoperative nausea and vomiting, duration of hospitalization, and quality of life. ⋯ IV lidocaine significantly improves postoperative pain after complex spine surgery.
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Journal of anesthesia · Jun 2014
Meta AnalysisThe impact of prophylactic intravenous lidocaine on opioid-induced cough: a meta-analysis of randomized controlled trials.
Opioids are commonly used for general anesthesia, but reflex cough can occur after an intravenous injection. We have performed a meta-analysis of randomized controlled trials (RCTs) that evaluated the effectiveness and safety of prophylactic lidocaine administered intravenously (IV) on opioid-induced cough (OIC) during induction in patients undergoing general anesthesia. ⋯ Our meta-analysis establishes the effectiveness of prophylactic lidocaine administered IV for the prevention of OIC during induction. The lowest effective dose of lidocaine on the risk of OIC appeared to be 0.5 mg/kg.
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Anesthesia and analgesia · Apr 2004
Randomized Controlled Trial Clinical TrialPerioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery.
Sodium channel blockers are approved for IV administration in the treatment of neuropathic pain states. Preclinical studies have suggested antihyperalgesic effects on the peripheral and central nervous system. Our objective in this study was to determine the time course of the analgesic and antihyperalgesic mechanisms of perioperative lidocaine administration. Forty patients undergoing major abdominal surgery participated in this randomized and double-blinded study. Twenty patients received lidocaine 2% (bolus injection of 1.5 mg/kg in 10 min followed by an IV infusion of 1.5 mg. kg(-1). h(-1)), and 20 patients received saline placebo. The infusion started 30 min before skin incision and was stopped 1 h after the end of surgery. Lidocaine blood concentrations were measured. Postoperative pain ratings (numeric rating scale of 0-10) and morphine consumption (patient-controlled analgesia) were assessed up to 72 h after surgery. Mean lidocaine levels during surgery were 1.9 +/- 0.7 microg/mL. Patient-controlled analgesia with morphine produced good postoperative analgesia (numeric rating scale at rest,
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Minerva anestesiologica · Dec 2013
Review Meta AnalysisThe Efficacy of Intravenous Lidocaine versus Placebo on Attenuating Cardiovascular Response to Laryngoscopy and Tracheal Intubation: A Systematic Review of Randomized Controlled Trials.
Cardiovascular response to laryngoscopy and tracheal intubation may be harmful in surgical patients with cardiovascular and cerebral diseases. The efficacy of intravenous lidocaine on attenuating the hemodynamic changes remains controversial. This systematic review aims to determine the efficacy of lidocaine versus placebo. ⋯ No significant publication bias across trials was found. Intravenous lidocaine helps reduce cardiovascular responses to laryngoscopy and tracheal intubation in patients of all age groups compared to placebo. Further studies are needed to clarify the effects of dosage and timing of lidocaine on hemodynamic changes.
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Review Meta Analysis Comparative Study
An estimation for an appropriate end time for an intraoperative intravenous lidocaine infusion in bowel surgery: a comparative meta-analysis.
There exists no commonly accepted regimen for an intravenous lidocaine infusion (IVLI). This study aims to determine an appropriate end time for an IVLI during bowel surgery. ⋯ Continuing an IVLI beyond 60 minutes after surgery has no added analgesic or gastrointestinal benefit. Further research is needed to clarify an optimal IVLI regimen and end time.
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Curr Opin Anaesthesiol · Aug 2014
ReviewSystemic lidocaine in surgical procedures: effects beyond sodium channel blockade.
This review presents current data on the systemic administration of lidocaine. The focus is on studies in the perioperative setting. In addition, there is a brief look at experimental data on the effect of lidocaine at the molecular level. ⋯ Positive effects on postoperative pain, as well as on bowel motility and hospital discharge time, have regularly been observed. However, contradictory findings have also been published. As almost all of the studies only include very small patient numbers, large multicenter investigations are needed.
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Glycine transporter 1 (GlyT1) plays a crucial role in regulating extracellular glycine concentrations and might thereby constitute a new drug target for the modulation of glycinergic inhibition in pain signaling. Consistent with this view, inhibition of GlyT1 has been found to induce antinociceptive effects in various animal pain models. We have shown previously that the lidocaine metabolite N-ethylglycine (EG) reduces GlyT1-dependent glycine uptake by functioning as an artificial substrate for this transporter. ⋯ Additionally, we found that EG reduced the increase in neuronal firing of wide-dynamic-range neurons caused by inflammatory pain induction. These findings suggest that systemically applied lidocaine exerts antihyperalgesic effects through its metabolite EG in vivo, by enhancing spinal inhibition of pain processing through GlyT1 modulation and subsequent increase of glycine concentrations at glycinergic inhibitory synapses. EG and other substrates of GlyT1, therefore, may be a useful therapeutic agent in chronic pain states involving spinal disinhibition.
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Randomized Controlled Trial Comparative Study
Lack of impact of intravenous lidocaine on analgesia, functional recovery, and nociceptive pain threshold after total hip arthroplasty.
The analgesic effect of perioperative low doses of intravenous lidocaine has been demonstrated after abdominal surgery. This study aimed to evaluate whether a continuous intravenous low-dose lidocaine infusion reduced postoperative pain and modified nociceptive pain threshold after total hip arthroplasty. ⋯ Low dose perioperative intravenous lidocaine after total hip arthroplasty offers no beneficial effect on postoperative analgesia and does not modify pressure and tactile pain thresholds.
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Anesthesia and analgesia · Dec 2009
Randomized Controlled TrialSystemic lidocaine decreased the perioperative opioid analgesic requirements but failed to reduce discharge time after ambulatory surgery.
In this randomized, blinded, placebo-controlled trial, we evaluated whether systemic lidocaine would reduce pain and time to discharge in ambulatory surgery patients. ⋯ Perioperative systemic lidocaine significantly reduces opioid requirements in the ambulatory setting without affecting time to discharge.
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Reg Anesth Pain Med · May 2011
Randomized Controlled Trial Comparative Study Clinical TrialIntravenous lidocaine versus thoracic epidural analgesia: a randomized controlled trial in patients undergoing laparoscopic colorectal surgery using an enhanced recovery program.
Laparoscopy, thoracic epidural analgesia, and enhanced recovery program (ERP) have been shown to be the major elements to facilitate the postoperative recovery strategy in open colorectal surgery. This study compared the effect of intraoperative and postoperative intravenous (IV) lidocaine infusion with thoracic epidural analgesia on postoperative restoration of bowel function in patients undergoing laparoscopic colorectal resection using an ERP. ⋯ Intraoperative and postoperative IV infusion of lidocaine in patients undergoing laparoscopic colorectal resection using an ERP had a similar impact on bowel function compared with thoracic epidural analgesia.
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Anesthesia and analgesia · Nov 2012
Randomized Controlled TrialThe effect of perioperative intravenous lidocaine and ketamine on recovery after abdominal hysterectomy.
Perioperative ketamine infusion reduces postoperative pain; perioperative lidocaine infusion reduces postoperative narcotic consumption, speeds recovery of intestinal function, improves postoperative fatigue, and shortens hospital stay. However, it is unknown whether perioperative IV lidocaine and/or ketamine enhances acute functional recovery. We therefore tested the primary hypothesis that perioperative IV lidocaine and/or ketamine in patients undergoing open abdominal hysterectomy improves rehabilitation as measured by a 6-minute walk distance (6-MWD) on the second postoperative morning. ⋯ Our results do not support use of lidocaine or ketamine for improving 6-MWD on the second postoperative day after open hysterectomy.
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Acta Anaesthesiol Scand · Mar 2015
Randomized Controlled TrialIntravenous lidocaine increases the depth of anaesthesia of propofol for skin incision - a randomised controlled trial.
The anaesthetic potency of intravenous propofol is quantified by its Cp50 value, which is defined as the plasma concentration required to prevent movement response in 50% of patients to surgical stimuli. We hypothesised that, in addition to propofol anaesthesia, an intravenous bolus of lidocaine 1.5 mg/kg will decrease the Cp50 value of propofol during anaesthesia. ⋯ An intravenous bolus injection of 1.5 mg/kg lidocaine 2% caused a significant reduction of the propofol Cp50 value.
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Anesthesia and analgesia · Dec 2004
Randomized Controlled Trial Clinical TrialIntravenous lidocaine suppresses fentanyl-induced coughing: a double-blind, prospective, randomized placebo-controlled study.
IV lidocaine is effective in suppressing the cough reflex of tracheal intubation, extubation, bronchography, bronchoscopy, and laryngoscopy. We investigated this effect of lidocaine on fentanyl-induced cough in 502 patients of ASA physical status I and II scheduled for elective surgery. ⋯ Coughs were classified as coughing and graded as mild (1-2), moderate (3-4), or severe (5 or more). The results of the study suggest that IV lidocaine 1.5 mg/kg, when administered 1 min before fentanyl, is significantly effective in suppressing fentanyl-induced cough compared to placebo (0.9% saline) (218 versus 165 patients) (P < 0.002) but without affecting the severity of cough (P > 0.05).
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Randomized Controlled Trial Clinical Trial
Intravenous lidocaine 0.5 mg.kg-1 effectively suppresses fentanyl-induced cough.
To evaluate the minimal dose of lidocaine required for suppression of fentanyl-induced cough. ⋯ The results of our study suggest that iv lidocaine 0.5 mg.kg(-1) is the minimal dose required to suppress fentanyl-induced cough when administered one minute prior to fentanyl. Any further increase in the lidocaine dose does not reduce the incidence or severity of fentanyl-induced cough.
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Review Meta Analysis
Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials.
Various strategies have been proposed for postoperative pain control. Among those, intravenous lidocaine infusion (IVLI) has gained in interest. However, its clinical benefit remains unclear. This systematic review is an evaluation of the analgesic efficacy and safety of IVLI during general anesthesia. ⋯ Perioperative IVLI reduced postoperative pain and opioid requirement, as well as ileus recovery time, hospital length of stay, and nausea/vomiting. Intravenous lidocaine infusion was effective mainly in abdominal surgery populations. Considering that toxic levels were detected and that adverse events were not systematically screened for in most studies, dose and safety of IVLI should be established before recommending its use.
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Journal of anesthesia · Oct 2014
Randomized Controlled TrialHemodynamic effects of topical lidocaine on the laryngoscope blade and trachea during endotracheal intubation: a prospective, double-blind, randomized study.
Minimizing hemodynamic changes during the peri-intubation period is a concern for anesthesiologists. We investigated the effect of lidocaine sprayed on the laryngoscope blade and trachea on hemodynamics during direct laryngoscopic intubation. ⋯ Lidocaine sprayed on the laryngoscope blade and/or trachea reduced the hemodynamic response to laryngoscopic intubation during the post-intubation period following anesthetic induction with remifentanil and propofol using a TCI device.
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Acta Anaesthesiol Scand · May 2010
Randomized Controlled Trial Comparative StudyLidocaine vs. magnesium: effect on analgesia after a laparoscopic cholecystectomy.
This double-blinded study aimed at evaluating and comparing the effects of magnesium and lidocaine on pain, analgesic requirements, bowel function, and quality of sleep in patients undergoing a laparoscopic cholecystectomy (LC). ⋯ I.v. lidocaine and magnesium improved post-operative analgesia and reduced intraoperative and post-operative opioid requirements in patients undergoing LC. The improvement of quality of recovery might facilitate rapid hospital discharge.
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Reg Anesth Pain Med · Jul 2010
Randomized Controlled Trial Comparative StudyIntravenous lidocaine is as effective as epidural bupivacaine in reducing ileus duration, hospital stay, and pain after open colon resection: a randomized clinical trial.
Both postoperative epidural analgesia and intravenous (IV) infusion of local anesthetic have been shown to shorten ileus duration and hospital stay after colon surgery when compared with the use of systemic narcotics alone. However, they have not been compared directly with each other. ⋯ No differences were observed between groups in terms of return of bowel function, duration of hospital stay, and postoperative pain control, suggesting that IV infusion of local anesthetic may be an effective alternative to epidural therapy in patients in whom epidural anesthesia is contraindicated or not desired.
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Randomized Controlled Trial
The effect of intravenous lidocaine on QT changes during tracheal intubation.
Laryngoscopy and tracheal intubation may provoke changes of cardiac repolarisation. The aim of this study was to assess the effect of intravenous lidocaine on the ECG changes induced by laryngoscopy and tracheal intubation. Forty-three female patients were randomly allocated to receive lidocaine (1.5 mg.kg(-1)) or placebo immediately after induction of anaesthesia and changes in the ECG and arterial blood pressure were recorded. ⋯ In the placebo group, significant increases in QTcb, QTcf and QTcF values were observed after intubation compared to either control measurements or to comparative measurements in the lidocaine group. There were no significant differences in TDR either between or within the groups. Lidocaine diminishes prolongation of QTc, induced by tracheal intubation but there is no effect of intubation on TDR.
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Cochrane Db Syst Rev · Jan 2015
Review Meta AnalysisContinuous intravenous perioperative lidocaine infusion for postoperative pain and recovery.
Perioperative lignocaine infusion reduces postoperative pain and nausea, and may improve GIT function and speed hospital discharge.
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Randomized Controlled Trial Clinical Trial
Facilitation of laryngeal mask insertion. Effects of lignocaine given intravenously before induction with propofol.
The effects of pretreatment with lignocaine administered intravenously on the insertion of the laryngeal mask airway were investigated in 80 unpremedicated, ASA 1 or 2, adult day-case patients in a randomised, double-blind, placebo-controlled trial. Patients received either intravenous lignocaine 1.5 mg.kg-1 or an equivalent volume of sodium chloride 0.9%. Induction of anaesthesia was achieved with propofol given via a syringe driver at a fixed rate of 600 ml.h-1 until the patient dropped a weighted syringe. ⋯ There were no differences between the lignocaine and control groups with respect to induction dose of propofol, degree of jaw opening, or amount of gagging. Laryngeal mask insertion was facilitated by pretreatment with lignocaine administered intravenously, without an alteration in induction dose of propofol (p < 0.05). Coughing and airway obstruction were both significantly reduced by pretreatment with lignocaine, as was the incidence of failure of insertion requiring deepening of anaesthesia (p < 0.05).
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Randomized Controlled Trial Clinical Trial
Intravenous lignocaine and sympathoadrenal responses to laryngoscopy and intubation. The effect of varying time of injection.
We have studied the effect of varying the timing of a prior dose of intravenous lignocaine 1.5 mg/kg on the cardiovascular and catecholamine responses to tracheal intubation. Forty healthy patients were given an intravenous injection of either placebo or lignocaine 2, 3 or 4 minutes before tracheal intubation. There was a significant increase in heart rate of 21-26% in all groups. There was no significant increase in mean arterial pressure in response to intubation in any group of patients given lignocaine before intubation, but in the placebo group, mean arterial pressure increased by 19.1% compared to baseline values (p less than 0.05).
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Randomized Controlled Trial
Effect of intravenous lidocaine on the transcerebral inflammatory response during cardiac surgery: a randomized-controlled trial.
Postoperative cognitive dysfunction (POCD) occurs frequently after cardiac surgery. The pathophysiology of POCD remains elusive, but previous work showed that intravenous lidocaine may be protective against POCD, possibly by modulating cerebral inflammation. We hypothesized that intravenous lidocaine would attenuate the cerebral inflammatory response to cardiopulmonary bypass (CPB) by reducing the transcerebral activation gradients of platelets, leukocytes, and/or platelet-leukocyte conjugates. ⋯ While lidocaine did not affect the systemic or transcerebral activation of platelets or leukocytes, we did observe a reduction in the transcerebral activation of platelet-monocyte conjugates after aortic cross-clamp release. This may be a manifestation of reduced cerebral inflammation during cardiopulmonary bypass in response to treatment with lidocaine. This trial was registered at ClinicalTrials.gov (NCT00938964).
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Meta Analysis Comparative Study
Intra-articular lidocaine versus intravenous analgesia and sedation for manual closed reduction of acute anterior shoulder dislocation: an updated meta-analysis.
To compare intra-articular lidocaine (IAL) with intravenous analgesia and sedation (IVAS) for manual closed reduction of acute anterior shoulder dislocation. ⋯ Intra-articular lidocaine injection may be safer than IVAS because there are fewer risks of postoperative complications with IAL. Both techniques are similarly effective for manual closed reduction of acute anterior shoulder dislocation.
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Review Meta Analysis
Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis.
Intravenous lidocaine improves postoperative analgesia at 4h and 24h after laparoscopic or open abdominal surgery, but not at 48h or for other surgery types.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Randomized Controlled Trial Comparative StudyComparison of Effects of Thoracic Epidural and Intravenous Administration of Lidocaine on Target-Controlled Infusion of Propofol and Tracheal Intubation Response During Induction of Anesthesia.
To compare the effects of thoracic epidural anesthesia (TEA) and intravenous (IV) lidocaine on the effect-site concentration (Ce) of propofol target-controlled infusion (TCI) and the intubation-induced stress responses during general IV anesthesia induction. ⋯ Lidocaine administered via both TEA and IV decreased the induction doses of propofol and suppressed cardiovascular and stress responses to tracheal intubation. Administration of 2mg/kg of 2% lidocaine IV was better, with no side effects of lidocaine toxicity.
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialClonidine versus ketamine to prevent tourniquet pain during intravenous regional anesthesia with lidocaine.
Both clonidine and ketamine have been found to prolong the action of local anesthetics through a peripheral mechanism. Our study compares the efficacy of a low dose of clonidine or ketamine separately added to intravenous regional anesthesia (IVRA) with lidocaine to prevent tourniquet pain. ⋯ The addition of clonidine 1 microg/kg or ketamine 0.1 mg/kg to lidocaine for IVRA delays the onset of unbearable tourniquet pain and decreases analgesic consumption for tourniquet pain relief, although ketamine has a more potent effect.
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Randomized Controlled Trial
No benefit from perioperative intravenous lidocaine in laparoscopic renal surgery: a randomised, placebo-controlled study.
There is evidence that perioperative intravenous lidocaine administration can reduce analgesic requirement, improve recovery of bowel function and shorten the length of hospital stay. Its effect in laparoscopic renal surgery has not been investigated. ⋯ Systemic perioperative lidocaine administration over 24 h did not influence the length of the hospital stay, readiness for discharge, opioid consumption, return of bowel function or inflammatory and stress responses after laparoscopic renal surgery.
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Randomized Controlled Trial
Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy.
Intravenous lidocaine given both intraoperatively and postoperatively decreases pain scores, reduces opioid consumption, and promotes faster return of bowel function following abdominal surgery. The purpose of this trial was to determine if intravenous lidocaine limited to the intraoperative period reduces length of hospital stay and improves functional recovery following abdominal hysterectomy. ⋯ Intraoperative administration of intravenous lidocaine did not reduce hospital stay or improve objective measures of analgesia and recovery following abdominal hysterectomy. This trial was registered at ClinicalTrials.gov (NCT00382499).
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Reg Anesth Pain Med · Nov 2014
Randomized Controlled TrialEffect of Intravenous Lidocaine on Postoperative Recovery of Patients Undergoing Mastectomy: A Double-Blind, Placebo-Controlled Randomized Trial.
One of the modalities of treatment for breast cancer surgery pain is opioids, and opioids are associated with adverse effects such as itching and postoperative nausea and vomiting (PONV). Intravenous (IV) lidocaine has been shown to reduce opioid consumption and to improve overall postoperative outcomes in abdominal surgery. In this study, we tested the effect of intraoperative IV lidocaine infusion on the quality of postoperative recovery after breast cancer surgery. ⋯ Our findings did not show a significant effect of IV lidocaine during breast cancer surgery on opioid consumption, pain score, PONV, or fatigue, indicating that the benefit of this approach does not generalize across all types of surgery.
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Anesthesia and analgesia · Nov 2009
Randomized Controlled TrialThe effect of perioperative intravenous lidocaine on postoperative pain and immune function.
Surgery-associated tissue injury leads to nociception and inflammatory reaction, accompanied by increased production of proinflammatory cytokines. These cytokines can induce peripheral and central sensitization, leading to pain augmentation. Recently, a frequently used local anesthetic, lidocaine, was introduced as a part of a perioperative pain management technique. In addition to its analgesic effects, lidocaine has an antiinflammatory property, decreasing the upregulation of proinflammatory cytokines. We focused on the effects of preincisional and intraoperative IV lidocaine on pain intensity and immune reactivity in the postoperative period. ⋯ The present findings indicate that preoperative and intraoperative IV lidocaine improves immediate postoperative pain management and reduces surgery-induced immune alterations.
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Lidocaine, a local anesthetic and antiarrhythmic drug that alters depolarization in neurons by blocking the fast voltage-gated sodium (Na+) channels in the cell membrane, is used for regional anesthesia, as antiarrhythmic drug, and as analgesic for various painful conditions. It is unclear whether monotherapy with intravenous lidocaine has an analgesic effect in healthy individuals. To address this important question, we studied pain perception before, during, and after the administration of intravenous lidocaine in 16 human volunteers. Our hypothesis was that lidocaine, administered as a short intravenous infusion, does not have an analgesic effect in healthy volunteers. ⋯ The observed sustained analgesic effect of systemic lidocaine in the ischemic pain model suggests that lidocaine may be used to treat acute pain.
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Anesthesia and analgesia · Aug 2013
Randomized Controlled TrialThe effect of a bolus dose of intravenous lidocaine on the minimum alveolar concentration of sevoflurane: a prospective, randomized, double-blinded, placebo-controlled trial.
The anesthetic effect of volatile anesthetics can be quantified by the minimum alveolar concentration (MAC) of the drug that prevents movement in response to a noxious stimulus in 50% of patients. The underlying mechanism regarding how immobilization is achieved by volatile anesthetics is not thoroughly understood, but several drugs affect MAC. In this study, we investigated the effect of a single IV bolus dose of lidocaine on the MAC of sevoflurane in humans. ⋯ IV 1.5 mg·kg(-1) lidocaine decreased the MAC by at least 0.03% sevoflurane (mean difference 0.23% sevoflurane [95% adjusted CI, 0.03-0.43]). We did not observe a significant reduction in the MAC of sevoflurane with the IV administration of 0.75 mg·kg(-1) lidocaine.
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Anesthesia and analgesia · Feb 2005
Randomized Controlled Trial Clinical TrialThe interaction effect of perioperative cotreatment with dextromethorphan and intravenous lidocaine on pain relief and recovery of bowel function after laparoscopic cholecystectomy.
Both dextromethorphan (DM) and IV lidocaine improve postoperative pain relief. In the present study, we evaluated the interaction of DM and IV lidocaine on pain management after laparoscopic cholecystectomy (LC). One-hundred ASA physical status I or II patients scheduled for LC were randomized into four equal groups to receive either: (a) chlorpheniramine maleate (CPM) intramuscular injection (IM) 20 mg and IV normal saline (N/S) (group C); (b) DM 40 mg IM and IV N/S (group DM); (c) CPM 20 mg IM and IV lidocaine 3 mg . kg(-1) . h(-1) (group L); or (d) DM 40 mg IM and IV lidocaine (group DM+L). ⋯ Patients of the DM+L group exhibited the best pain relief and fastest recovery of bowel function among groups. Patients in the DM and L groups had significantly better pain relief than those in the C group. The results showed an additional effect on pain relief and a synergistic effect on recovery of bowel function when DM was combined with IV lidocaine after LC.
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The neuroinflammatory response plays a key role in several pain syndromes. Intravenous (iv) lidocaine is beneficial in acute and chronic pain. This review delineates the current literature concerning in vitro mechanisms and in vivo efficacy of iv lidocaine on the neuroinflammatory response in acute and chronic pain. ⋯ Intravenous lidocaine has analgesic, anti-inflammatory and antihyperalgesic properties mediated by an inhibitory effect on ion channels and receptors. It attenuates the neuroinflammatory response in perioperative pain and chronic neuropathic pain.
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Randomized Controlled Trial Clinical Trial
Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl-induced cough.
The aim of this study was to evaluate the effectiveness of lidocaine, propofol and ephedrine in suppressing fentanyl-induced cough. ⋯ Intravenous lidocaine 2 mg.kg(-1) or ephedrine 5 mg, but not propofol 0.6 mg.kg(-1), was effective in preventing fentanyl-induced cough. The results provide a convenient method to decrease fentanyl-induced cough.
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Anesthesia and analgesia · Oct 1985
Randomized Controlled Trial Clinical TrialInhibition of postoperative pain by continuous low-dose intravenous infusion of lidocaine.
Intravenous lidocaine has been reported previously to inhibit postoperative pain when given either as single injections or as short infusions in amounts usually causing adverse reactions. To determine the efficacy of a continuous low-dose (2 mg/kg) intravenous infusion of lidocaine, postoperative pain (visual analogue pain scale) and the requirements for postoperative analgesics were measured in a double-blind randomized trial in 20 patients after cholecystectomy. Lidocaine infusion was started 30 min before the operation and continued for 24 hr after surgery (n = 10). ⋯ No adverse reactions to lidocaine were observed. Whole blood levels of lidocaine ranged between 1 and 2 micrograms/ml. The results suggest that low-dose continuous infusions of lidocaine decrease the severity of postoperative pain and are devoid of side effects.
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J Neurosurg Anesthesiol · Jul 2006
Randomized Controlled Trial Comparative StudyComparison of different extubation techniques in lumbar surgery: prone extubation versus supine extubation with or without prior injection of intravenous lidocaine.
The aim of this study was to evaluate the incidence of coughing and breath holding in patients undergoing lumbar surgery extubated in prone position, supine position, or supine position with intravenous lidocaine before extubation. About 105 ASA I to II patients undergoing lumbar surgery were extubated in prone position in group P (n = 35), in supine position in group S (n = 35) and in supine position with intravenous 1.5 mg/kg lidocaine 10 minutes before extubation in group SL (n = 35). The number of patients who coughed and demonstrated breath holding was noted at emergence period. ⋯ The incidence of breath holding in the first 6 minutes was lower in group P (n = 11) compared with groups S (n = 29) and SL (n = 25)(P = 0.001). The loss of monitoring time was longer in groups S (62 +/- 40 s) and SL (53 +/- 39 s) when compared with group P (0 s) (P < 0.01). Prone emergence and supine emergence with intravenous lidocaine provides an alternative approach to conventional supine emergence and prone extubation offers less cough and breath holding and continuation of monitoring.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of intravenous lidocaine and/or esmolol on hemodynamic responses to laryngoscopy and intubation: a double-blind, controlled clinical trial.
To evaluate the efficacy of intravenous lidocaine and two doses of esmolol for attenuating the cardiovascular responses to laryngoscopy and intubation, and to assess whether a combination of both drugs is more effective than either drug alone. ⋯ Esmolol 1 to 2 mg/kg is reliably effective in attenuating HR response to tracheal intubation. Neither of the two doses of esmolol tested nor that of lidocaine affected the BP response. Only the combination of lidocaine and esmolol attenuated both HR and BP responses to tracheal intubation.
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J Clin Monit Comput · Apr 2014
Lidocaine infusion adjunct to total intravenous anesthesia reduces the total dose of propofol during intraoperative neurophysiological monitoring.
Total intravenous anesthesia (TIVA) with propofol and opioids is frequently utilized for spinal surgery where somatosensory evoked potentials (SSEP) and motor evoked potentials (tcMEP) are monitored. Lidocaine infusions can contribute to antinociception and unconsciousness, thus allowing for a reduction in the total dose of propofol. We examined our recent experience with lidocaine infusions to quantify this effect. ⋯ No complications were associated with the use of the lidocaine infusion. The total estimated drug savings included 104 50 ml bottles of propofol and 5 5 ml ampules of sufentanil. These cases indicate that a lidocaine infusion can be effectively utilized in spine surgery with SSEP and tcMEP monitoring as a means to reduce propofol and sufentanil usage without a negative effect on the monitoring.
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Acta Anaesthesiol Scand · Apr 1991
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intravenous and topical lidocaine as a suppressant of coughing after bronchoscopy during general anesthesia.
Twenty-four consecutive patients scheduled for fiberbronchoscopy were randomized to receive double-blind either intravenous (1.5 mg/kg) or laryngotracheal (3 mg/kg) lidocaine to evaluate the influence on post-bronchoscopic laryngospasm, pain in the throat and coughing. Plasma lidocaine concentrations were analyzed 5, 15, 30 and 60 min after administration. ⋯ The plasma lidocaine concentrations were significantly higher after intravenous than after topical administration (P less than 0.001). After intravenous administration the plasma lidocaine concentrations exceeded the accepted level for potential toxicity in five out of 11 patients, but none of the patients developed toxic symptoms and no side-effects were observed.
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Anesthesia and analgesia · Aug 1993
Randomized Controlled Trial Clinical TrialIntravenous lidocaine as a suppressant of coughing during tracheal intubation in elderly patients.
The effects of intravenously administered lidocaine on cough suppression in elderly patients over the age of 60 yr during tracheal intubation under general anesthesia were evaluated in two studies. In the first study, 100 patients received a placebo of either 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously 1 min before tracheal intubation. All visible coughs were classified as coughing. ⋯ The incidence of coughing decreased significantly (P < 0.01) when 2 mg/kg lidocaine was injected intravenously between 1 min and 3 min before attempting intubation. The cough reflex was almost entirely suppressed by plasma concentrations of lidocaine in excess of 4 micrograms/mL. The results suggest that intravenous administration of lidocaine is effective in suppressing the cough reflex during tracheal intubation in elderly patients under general anesthesia, but that relatively high plasma concentrations of lidocaine may be required for suppression of coughing.
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Randomized Controlled Trial Clinical Trial
Effects of alkalinization of lidocaine on the pain of skin infiltration and intravenous catheterization.
To test the hypothesis that alkalinization of lidocaine decreases the pain of skin infiltration in surgical patients. ⋯ Pain resulting from skin infiltration of lidocaine solutions can be diminished by adding NaHCO3. However, catheter size is more important than the presence or absence of NaHCO3 in determining the pain of i.v. catheterization.
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Anesthesia and analgesia · May 1998
Randomized Controlled Trial Clinical TrialPremedication with fentanyl and midazolam decreases the reliability of intravenous lidocaine test dose.
This study was performed to determine whether premedication with midazolam and fentanyl prevents reliable detection of an i.v. lidocaine test dose. Thirty ASA physical status I or II patients received either 3 mL of saline or 1.5 mg of midazolam (1.5 mL) plus 75 microg of fentanyl (1.5 mL) i.v. in a randomized, double-blind fashion. Five minutes later, lidocaine 1 mg/kg was injected i.v. At 1.5 min before and every minute after lidocaine administration, each subject was questioned regarding the presence of four symptoms of systemic lidocaine toxicity. Any new tinnitus, perioral numbness, metallic taste, or light-headedness within 5 min after lidocaine administration was considered a positive response. All 15 patients in the saline group (100% sensitivity) had a positive response to i.v. lidocaine, but only 9 of 15 patients in the sedation group had a positive response (60% sensitivity; P = 0.017). We conclude that midazolam and fentanyl premedication decreases the reliability of subjective detection of i.v. lidocaine. ⋯ Anesthesiologists often rely on subjective symptoms to prevent local anesthetic toxicity while performing regional anesthesia. Sedatives are often administered during the administration of regional anesthesia. This study demonstrates that typical sedation decreases the reliability of detection of local anesthetic toxicity by subjective symptoms.
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Intravenous lidocaine infusion has been shown to reduce postoperative pain among patients undergoing abdominal surgery. This study aimed to evaluate the effects of perioperative lidocaine administration in breast surgery. ⋯ The results indicate no significant benefits of intravenous lidocaine infusion in terms of acute postoperative pain. Although lidocaine seems to attenuate the risk of chronic pain after breast surgery, there is insufficient evidence to conclude that lidocaine infusion is of proved benefit because the results were based on a limited number of small trials.
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Anesthesia and analgesia · Dec 1985
Clinical Trial Controlled Clinical TrialIntravenous lidocaine as a suppressant of coughing during tracheal intubation.
Effects of intravenously administered lidocaine on cough suppression during tracheal intubation under general anesthesia were evaluated in two studies. In study 1, 100 patients received either a placebo or 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously 1 min before tracheal intubation. All visible coughs were classified as coughing. ⋯ The same criteria for determining whether a patient did or did not cough during tracheal intubation were used as in study 1. The incidence of coughing decreased significantly (P less than 0.01) when 2 mg/kg of lidocaine was injected intravenously between 1 and 5 min before our attempting intubation. Cough reflex was suppressed completely by plasma concentrations of lidocaine in excess of 3 micrograms/ml.
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Randomized Controlled Trial Clinical Trial
Inhaled albuterol, but not intravenous lidocaine, protects against intubation-induced bronchoconstriction in asthma.
The ability of intravenous lidocaine to prevent intubation-induced bronchospasm is unclear. The authors performed a prospective, randomized, double-blind, placebo-controlled trial to test the ability of intravenous lidocaine and inhaled albuterol to attenuate airway reactivity after tracheal intubation in asthmatic patients undergoing general anesthesia. ⋯ Inhaled albuterol blunted airway response to tracheal intubation in asthmatic patients, whereas intravenous lidocaine did not.
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Acta Anaesthesiol Scand · Apr 2012
Randomized Controlled TrialIntravenous lidocaine has no impact on rocuronium-induced neuromuscular block. Randomised study.
Intravenous lidocaine is increasingly used in surgical patients. As it has neuromuscular blocking effects, we tested the impact of an intravenous lidocaine infusion on the time course of a rocuronium-induced neuromuscular block. ⋯ A continuous intravenous infusion of lidocaine has no impact on the time course of the neuromuscular blockade induced by a standard intubation dose of rocuronium.
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Randomized Controlled Trial
Lidocaine given intravenously improves conditions for laryngeal mask airway insertion during propofol target-controlled infusion.
Patient response to laryngeal mask airway insertion during propofol induction depends on many factors. Lidocaine has been used to reduce cardiovascular responses, coughing, and bucking induced by tracheal intubation. The aim of this study was to determine the effects of intravenous lidocaine on laryngeal mask airway insertion conditions during the induction of anaesthesia with propofol target-controlled infusion. ⋯ Pretreatment with intravenous lidocaine 1.5 mg kg during induction with propofol target-controlled infusion improves laryngeal mask airway insertion conditions.
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Anesthesia and analgesia · Feb 1998
Randomized Controlled Trial Clinical TrialIntravenous lidocaine speeds the return of bowel function, decreases postoperative pain, and shortens hospital stay in patients undergoing radical retropubic prostatectomy.
Postoperative ileus is a concern among surgical patients. Epidural anesthesia and analgesia with local anesthetics can decrease the duration of ileus. Significant systemic absorption of local anesthesia occurs during epidural use. In this study, we examined whether many of the beneficial effects on bowel function seen with epidural lidocaine are also present when the drug is given parenterally. Forty patients undergoing radical retropubic prostatectomy were studied with one half of the patients receiving a lidocaine bolus (1.5 mg/kg) and infusion (3 mg/min, unless weight <70 kg, then 2 mg/min); the other half received a saline infusion. A blind observer recorded the patient's daily pain score, the time the patient first experienced flatulence and had the first bowel movement, and the total use of analgesics. Lidocaine-treated patients first experienced flatulence in a significantly shorter time (P < 0.01) than control patients. Lidocaine patients' hospital stay was also significantly shorter (P < 0.05); on average, they spent 1.1 fewer days in the hospital. I.V. lidocaine initiated before anesthesia and continued 1 h postoperatively significantly sped up the return of bowel function. Lidocaine patients were also more comfortable postoperatively. Many of the bowel function benefits attributed to epidural lidocaine are also present when the drug is administered parenterally. Additionally, the length of hospital stay was reduced in lidocaine-treated patients. ⋯ This study prospectively examined whether I.V. lidocaine could affect the return of bowel function after radical prostate surgery. Lidocaine-treated patients had shorter hospital stays, less pain, and faster return of bowel function. In this population, lidocaine infusion can be a useful adjunct in anesthetic management.
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Anesthesia and analgesia · Jan 2007
Controlled Clinical TrialIntravenous lidocaine after tracheal intubation mitigates bronchoconstriction in patients with asthma.
Although prophylactic IV administration of lidocaine attenuates the response to a variety of inhalation challenges, its effect on airway resistance after endotracheal intubation in patients with asthma is unclear. We tested the hypothesis that IV lidocaine attenuates intubation-evoked bronchoconstriction in patients with asthma. ⋯ IV lidocaine given after endotracheal intubation mitigates bronchoconstriction in patients with asthma.
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Anesthesia and analgesia · Jul 1996
Randomized Controlled Trial Clinical TrialEquivalent outcomes during postoperative patient-controlled intravenous analgesia with lidocaine plus morphine versus morphine alone.
To evaluate a possible opioid-sparing effect of intravenous lidocaine we conducted a randomized, double-blind clinical trial. Patients undergoing intraabdominal surgery under general anesthesia were treated with patient-controlled analgesia (PCA) in three groups: Group 1 (n = 100; morphine 1 mg/mL), Group 2 (n = 44; morphine 1 mg/mL plus lidocaine 10 mg/mL), and Group 3 (n = 51; morphine 1 mg/mL plus lidocaine 20 mg/mL). Pain was evaluated using a 0-10 visual analog scale in the postanesthesia care unit (PACU) during deep inhalation at 15 and 30 min, and at 1, 2, and 4 h after arrival in the PACU, and continued after PACU discharge every 4 h for 36 h. ⋯ Along with pain intensity, we assessed vital signs and side effects. Time to acceptance of oral liquids was also determined. Adding lidocaine 10 or 20 mg/mL to PCA morphine 1 mg/mL for acute pain treatment after abdominal surgery yielded no differences in opioid use, pain levels, or side effects.
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Acta Anaesthesiol Scand · Apr 1983
Randomized Controlled Trial Clinical TrialLidocaine given intravenously as a suppressant of cough and laryngospasm in connection with extubation after tonsillectomy.
The preventive effect of lidocaine against coughing in the recovery period after general anaesthesia was observed. The study was carried out as a double-blind sequential trial. At the same time the incidence of laryngospasm was registered. ⋯ Nineteen patients for tonsillectomy, all of them over the age of 15, randomly received a 2% solution of lidocaine 2 mg/kg body weight or placebo (saline) 2 min prior to expected extubation. We found that lidocaine in this dose given prophylactically just before extubation was able to inhibit and prevent coughing in the recovery period after general anaesthesia. None of the patients included in this study got laryngospasm, and none of the patients developed serious side-effects.
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Journal of anesthesia · Oct 1990
Effects of intravenous or endotracheal lidocaine on circulatory changes during recovery from general anesthesia.
Intravenous lidocaine (1.5 mg.kg(-1)) was not effective in attenuating the circulatory changes and the cough reflex induced by airway stimulation during recovery from general anesthesia, whereas endotracheal 4% lidocaine (3 ml) was effective. The arterial concentration of the intravenously administered-lidocaine peaked at a level of 9.52 +/- 0.81 microg.ml(-1) 0.5 min later. The arterial concentration of the endotracheally administered-lidocaine peaked at 1.44 +/- 0.13 microg.ml(-1) 15 min later. These findings indicate that the endotracheal administration of lidocaine may be superior to the intravenous administration for attenuating the circulatory changes and the cough reflex during recovery from general anesthesia, and that the arterial concentration of lidocaine did not correlate with the clinical efficacy for this purpose.
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Review Meta Analysis
Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials.
Postoperative pain continues to be inadequately managed. While opioids remain the mainstay for postoperative analgesia, their use can be associated with adverse effects, including ileus, which can prolong hospital stay. A number of studies have investigated the use of perioperative intravenous lidocaine infusion for improving postoperative analgesia and enhancing recovery of bowel function. ⋯ In conclusion, intravenous lidocaine infusion in the perioperative period is safe and has clear advantages in patients undergoing abdominal surgery. Patients receiving lidocaine infusion had lower pain scores, reduced postoperative analgesic requirements and decreased intraoperative anaesthetic requirements, as well as faster return of bowel function and decreased length of hospital stay. Further studies are needed to assess whether lidocaine has a beneficial effect in patients undergoing other types of surgery and to determine the optimum dose, timing and duration of infusion of lidocaine in this setting.
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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%.
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Reg Anesth Pain Med · May 2016
Randomized Controlled TrialSystemic Lidocaine Fails to Improve Postoperative Pain, But Reduces Time to Discharge Readiness in Patients Undergoing Laparoscopic Sterilization in Day-Case Surgery: A Double-Blind, Randomized, Placebo-Controlled Trial.
Perioperative systemic lidocaine provides postoperative analgesia, decreases opioid consumption, and facilitates rehabilitation in abdominal surgery. We hypothesized that systemic lidocaine has analgesic effects in women undergoing day-case laparoscopic sterilization. ⋯ In laparoscopic sterilization, systemic lidocaine reduces time to readiness for hospital discharge.
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Cochrane Db Syst Rev · Jun 2018
Review Meta AnalysisContinuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults.
Even if beneficial, perioperative lignocaine infusions probably have no analgesic benefit beyond 24 hours post-operatively.
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Anesthesia and analgesia · Sep 2018
Randomized Controlled TrialIntravenously Administered Lidocaine and Magnesium During Thyroid Surgery in Female Patients for Better Quality of Recovery After Anesthesia.
Although systemic lidocaine and magnesium have been widely studied as perioperative analgesic adjuvants, they have been rarely evaluated with respect to recovery quality under the same conditions. We compared the quality of recovery 40 (QoR-40) scores of female patients who received intravenous lidocaine, magnesium, and saline during thyroidectomy to investigate their effects on comprehensive recovery from anesthesia. ⋯ Lidocaine administered intravenously during anesthesia led to better quality of postoperative recovery measured by QoR-40 compared with the group C. Magnesium was found to be insufficient to induce any significant improvement with the dose used in the present study.
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Journal of anesthesia · Dec 2013
Case ReportsIntravenous lidocaine and magnesium for management of intractable trigeminal neuralgia: a case series of nine patients.
Most patients suffering from trigeminal neuralgia (TN) benefit from medical therapy, for example carbamazepin, gabapentin, and pregabalin, individually or in combination. Nonetheless, some patients experience severe and intractable pain despite such medication, or the medication eliminates their pain but they experience intolerable side effects sufficient to warrant discontinuation. ⋯ All patients experienced sound pain relief after the combined intravenous infusion therapy. Two patients experienced short and mild dizziness after the therapy, but no severe side effects were reported.
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Anesthesia and analgesia · Sep 2018
Editorial CommentAnother Win for Lidocaine, Another Loss for Magnesium?
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