Equivalent Outcomes During Postoperative Patient-Controlled Intravenous Analgesia with Lidocaine Plus Morphine Versus Morphine Alone

Cepeda, M. Soledad; Delgado, Martha; Ponce, M; Cruz, Carlos A.; Carr, Daniel B.

doi:10.1213/00000539-199607000-00018

Cited by 60 publications

(4 citation statements)

References 21 publications

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“…However, based on the pain scores, the three treatments provided similar analgesia and adding lidocaine to morphine did not influence the postoperative opioid requirement. These results support the findings of Cepeda et al 31 who reported no differences in analgesic effects and postoperative opioid requirements using morphine or morphine plus lidocaine infusions.…”

Section: Variablesupporting

confidence: 92%

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Analgesic comparison of systemic lidocaine, morphine or lidocaine plus morphine infusion in dogs undergoing fracture repair

et al. 2014

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Intellectual and scientific content of the study, statistical analysis, critical revision. ABSTRACT PURPOSE:To compare the postoperative analgesic effects of lidocaine, morphine and lidocaine plus morphine administered by constant rate infusion (CRI) and analyzing their effects on opioid requirements after orthopedic surgery in dogs. METHODS:Twenty-four dogs underwent fracture repairs were premedicated with IM acepromazine (0.05 mg/kg) combined with morphine (0.3mg/kg). Anesthesia was induced with IV propofol (4 to 5 mg/ kg) and maintained with isoflurane. The dogs were randomly assigned to 3 groups and administered a CRI IV of lidocaine (T-L), morphine (T-M) or lidocaine plus morphine (T-LM) at the same doses. Postoperative analgesia was assessed for 24 hours using a Visual Analog Scale (VAS) and the Glasgow Composite Pain Scale (GCPS). Rescue analgesia was performed if the evaluation score exceeded 50% of the VAS and/or 33% of the GCPS. RESULTS:The pain score and postoperative opioid requirements did not differ among the treatments. Rescue analgesia was administered to 1/8 dogs in the T-M and T-LM, and to 3/8 dogs in the T-L. CONCLUSION:Lidocaine, morphine or lidocaine/morphine CRI may be efficacious techniques for pain management in the first 24 hours post-surgery. However, the two drugs administered together did not reduce the postoperative opioid requirement in dogs undergoing fracture repair.

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Section: Variablesupporting

confidence: 92%

“…Controversially, other studies have reported that systemic lidocaine neither reduced pain scores or induced any postoperative opioid-sparing effect [31][32][33] .…”

Section: Discussionmentioning

confidence: 95%

Analgesic comparison of systemic lidocaine, morphine or lidocaine plus morphine infusion in dogs undergoing fracture repair

et al. 2014

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“…This raises the question of whether other PCA morphine dosages could have been used. However, the dose regimen chosen by us was based on our current clinical routines, which in turn closely agree with doses employed in recent studies, as exemplified by the reports from Cepeda et al (15) and Wheatley et al (16). Further, the actual delivered dose of morphine in the PCA group was high enough to produce significant respiratory depression.…”

Section: Discussionsupporting

confidence: 61%

Continuous interscalene brachial plexus block for postoperative analgesia following shoulder surgery

Lehtipalo¹,

Koskinen²,

Johansson³

et al. 1999

Acta Anaesthesiol Scand

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“…The first four systematic reviews [20][21][22][23], published between 2008 and 2012, drew on the same pool of primary trials of lidocaine in abdominal surgery [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42].…”

Section: Methodology Of Consensus Statementmentioning

confidence: 99%

The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety

et al. 2020

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Summary Intravenous lidocaine is used widely for its effect on postoperative pain and recovery but it can be, and has been, fatal when used inappropriately and incorrectly. The risk‐benefit ratio of i.v. lidocaine varies with type of surgery and with patient factors such as comorbidity (including pre‐existing chronic pain). This consensus statement aims to address three questions. First, does i.v. lidocaine effectively reduce postoperative pain and facilitate recovery? Second, is i.v. lidocaine safe? Third, does the fact that i.v. lidocaine is not licensed for this indication affect its use? We suggest that i.v. lidocaine should be regarded as a ‘high‐risk’ medicine. Individual anaesthetists may feel that, in selected patients, i.v. lidocaine may be beneficial as part of a multimodal peri‐operative pain management strategy. This approach should be approved by hospital medication governance systems, and the individual clinical decision should be made with properly informed consent from the patient concerned. If i.v. lidocaine is used, we recommend an initial dose of no more than 1.5 mg.kg‐1, calculated using the patient’s ideal body weight and given as an infusion over 10 min. Thereafter, an infusion of no more than 1.5 mg.kg‐1.h‐1 for no longer than 24 h is recommended, subject to review and re‐assessment. Intravenous lidocaine should not be used at the same time as, or within the period of action of, other local anaesthetic interventions. This includes not starting i.v. lidocaine within 4 h after any nerve block, and not performing any nerve block until 4 h after discontinuing an i.v. lidocaine infusion.

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Equivalent Outcomes During Postoperative Patient-Controlled Intravenous Analgesia with Lidocaine Plus Morphine Versus Morphine Alone

Cited by 60 publications

References 21 publications

Analgesic comparison of systemic lidocaine, morphine or lidocaine plus morphine infusion in dogs undergoing fracture repair

Analgesic comparison of systemic lidocaine, morphine or lidocaine plus morphine infusion in dogs undergoing fracture repair

Continuous interscalene brachial plexus block for postoperative analgesia following shoulder surgery

The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety

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