Clinical Efficacy of Intravenous Lidocaine for Thyroidectomy: A Prospective, Randomized, Double‐Blind, Placebo‐Controlled Trial

Choi, Geun Joo; Kang, Hyun; Ahn, Eun Jin; Oh, Je Hyeok; Baek, Chong Wha; Jung, Yong Hun; Kim, Jin Yun

doi:10.1007/s00268-016-3619-6

Cited by 29 publications

(40 citation statements)

References 35 publications

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“…Of the 17 studies, seven (Teksoz et al, Choi et al, Miu et al, Kang et al, Kesisoglou et al, Ekinci et al, and Ahiskalioglu et al) reported statistically significant decreases in VAS and NRS postoperative pain scores. 23,25,27,28,35,36,40 Teksoz et al found lower VAS scores at 30 minutes, 1 hour, and at 8 hour postoperatively ( P = .03, P = .04, P = .005, respectively). 23 Kesisoglou similarly reported significantly decreased VAS scores at 0, 3, 6, 9, 12, and 24 hours after surgery ( P < .05).…”

Section: Resultsmentioning

confidence: 94%

“…The total amount of PCA consumption (10 mg/mL meperidine) also did not differ significantly ( P > .05). 33 In regards to rescue analgesic medications, four studies (Kang et al 28 [Fentanyl: 510.75 μg vs 422.50 μg; P < .05], Choi et al 25 [Fentanyl: 550.79 ± 46.46 μg vs 598.57 ± 55.58 μg; P < .01], Karthikeyan et al 31 [Morphine PCA: 30.70 ± 4.77 mg vs 0.85 ± 3.95 mg; P = .001], and Ekinci et al 36 [Tramadol: 72.4 ± 24.5 mg vs 91.5 ± 36.8 mg; P = .027]) reported statistically significant decreases in need for additional medication. Eight studies compared bilateral superficial cervical plexus block (BSCPB) encompassing 274 patients.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 21 studies explored the role of local anesthetics in thyroid and parathyroid surgery. 11,12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Twenty of the studies were prospective RCTs and one study was retrospective. Extended details for these studies can be found in Supplemental 23,25,27,28,35,36,40 Teksoz et al found lower VAS scores at 30 minutes, 1 hour, and at 8 hour postoperatively (P = .03, P = .04, P = .005, respectively).…”

Section: Local Anestheticsmentioning

confidence: 99%

“…11,12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Twenty of the studies were prospective RCTs and one study was retrospective. Extended details for these studies can be found in Supplemental 23,25,27,28,35,36,40 Teksoz et al found lower VAS scores at 30 minutes, 1 hour, and at 8 hour postoperatively (P = .03, P = .04, P = .005, respectively). 23 Kesisoglou similarly reported significantly decreased VAS scores at 0, 3, 6, 9, 12, and 24 hours after surgery (P < .05).…”

Section: Local Anestheticsmentioning

confidence: 99%

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Perioperative Analgesia for Patients Undergoing Thyroidectomy and Parathyroidectomy: An Evidence-Based Review

Nguyen

Stathakios

Quan

et al. 2020

Ann Otol Rhinol Laryngol

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Objective: To perform an evidence-based systematic review evaluating perioperative analgesia, including opioid alternatives, used for patients undergoing thyroidectomy and parathyroidectomy. Methods: A comprehensive literature search from 1997 to January 2018 of Pubmed, Cochrane, and EmBase libraries was performed for studies reporting analgesic administration following thyroid or parathyroid surgery. This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies were evaluated for level of evidence and given a Jadad score to assess for risk of bias. Outcomes gathered included postoperative pain scores, time to rescue analgesia, rescue analgesic consumption, and adverse events. Results: Thirty-eight randomized controlled trials met inclusion criteria. The GRADE criteria determined the overall evidence to be moderate-high. Studies utilizing NSAIDs reported reduced requirements for rescue analgesics. Acetaminophen studies presented with conflicting data on effectiveness. Gabapentinoid studies demonstrated lower pain scores and an increased time to rescue analgesic. Local anesthetics were effective at decreasing Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS) pain scores while also reducing rescue analgesic consumption. Ketamine was shown to increased postoperative nausea and vomiting. NSAIDs and local anesthetic studies had an aggregate grade of evidence A, while all others had grade B evidence. Conclusion: There is significant evidence supporting the use of NSAIDs and local anesthetics in the perioperative period for pain management for thyroid and parathyroid surgeries. Acetaminophen, gabapentinoid and ketamine have some supporting evidence and may serve as adequate alternatives. Further multi-institutional RCTs are warranted to delineate optimal analgesic regimens. Level of Evidence: NA

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Local Anestheticsmentioning

confidence: 99%

Section: Local Anestheticsmentioning

confidence: 99%

See 2 more Smart Citations

Perioperative Analgesia for Patients Undergoing Thyroidectomy and Parathyroidectomy: An Evidence-Based Review

Nguyen

Stathakios

Quan

et al. 2020

Ann Otol Rhinol Laryngol

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“…A recent meta-analysis found that the efficacy of perioperative intravenous lidocaine for postoperative pain varies between surgical procedures [8]. Indeed, opioid sparing was observed after lidocaine infusion in open abdominal [9, 10] and laparoscopic [11, 12] procedures, thyroid surgery [13], and cardiac [14], thoracic [15], and major spine [16] procedures. Moreover, data suggest a reduction of CPSP development in breast surgery [4, 17].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of intravenous lidocaine in head and neck cancer surgery: study protocol for a randomized controlled trial

Omar

Wallon

Bauer

et al. 2019

Trials

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Background Pain after major head and neck cancer surgery is underestimated and has both nociceptive and neuropathic characteristics. Extended resection, flap coverage, nerve lesions, inflammation, and high-dose opioid administration can also lead to hyperalgesia and chronic postoperative pain. Opioids are frequently associated with adverse events such as dizziness, drowsiness, nausea and vomiting, or constipation disturbing postoperative recovery and extending the length of hospital stay. Patients eligible for major head and neck cancer surgery cannot benefit from full multimodal pain management with locoregional anesthesia. Intravenous lidocaine, investigated in several studies, has been found to decrease acute pain and morphine consumption. Some data suggest also that it can prevent chronic postsurgical pain. Evidence supporting its use varies between surgical procedures, and there is no published study regarding systemic lidocaine administration in major head and neck cancer surgery. We hypothesized that intravenous lidocaine infused in the perioperative period would lead to opioid sparing and chronic postsurgical pain reduction. Methods/design A total of 128 patients undergoing major head and neck surgery will be included in this prospective two-center, double-blind, randomized controlled trial. Patients will be randomly assigned to lidocaine or placebo treatment. After induction of general anesthesia, an intravenous lidocaine bolus will be administered (1.5 mg.kg − 1 ), followed by a continuous infusion (2 mg.kg − 1 .h − 1 ) which will be reduced in the postanesthesia care unit (1 mg.kg − 1 .h − 1 ). The primary outcome measure is morphine consumption 48 h after surgery. The secondary outcomes include intraoperative remifentanil consumption, morphine consumption 24 h after surgery, and chronic postsurgical pain that will be assessed 3–6 months after surgery. Discussion Recent evidence suggests that intravenous lidocaine can lead to opioid sparing and chronic postsurgical pain reduction for certain types of surgery. This is the first trial to prospectively investigate the efficacy and safety of intravenous lidocaine in major head and neck cancer surgery. Trial registration ClinicalTrials.gov, NCT02894710 . Registered on 11 August 2016. Electronic supplementary material The online version of this article (10.1186/s13063-019-3303-x) contains supplementary material, which is available to authorized users.

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Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults

Weibel

Jelting

Pace

et al. 2018

Cochrane Database of Systematic Reviews

265

268

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Clinical Efficacy of Intravenous Lidocaine for Thyroidectomy: A Prospective, Randomized, Double‐Blind, Placebo‐Controlled Trial

Abstract: Clinicaltrials.gov NCT01608360.

Cited by 29 publications

References 35 publications

Perioperative Analgesia for Patients Undergoing Thyroidectomy and Parathyroidectomy: An Evidence-Based Review

Perioperative Analgesia for Patients Undergoing Thyroidectomy and Parathyroidectomy: An Evidence-Based Review

Evaluation of intravenous lidocaine in head and neck cancer surgery: study protocol for a randomized controlled trial

Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults

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