Perioperative Intravenous Lidocaine Has Preventive Effects on Postoperative Pain and Morphine Consumption After Major Abdominal Surgery

Abstract

The perioperative administration of systemic small-dose lidocaine reduces pain during surgery associated with the development of pronounced central hyperalgesia, presumably by affecting mechanoinsensitive nociceptors, because these have been linked to the induction of central sensitization and were shown to be particularly sensitive to small-dose lidocaine.

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

“…In dogs, a bolus of 2 mg/kg followed by 100 µg/kg/min of lidocaine allowed the investigators to reduce isoflurane MAC by 27.3% [18]. Although the analgesic effects of systemic lidocaine have been demonstrated for chronic pain especially the neuropathic type, the results for acute pain have been contradictory [19]. Recent meta-analysis [9] has found a significant difference in pain control at rest, during cough, or during movement with the use of intravenous lidocaine infusion in surgical patients under general anesthesia.…”

Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials

“…24 Seven studies originated in the USA, [25][26][27][28][29][30][31] one in Belgium, 32 two in Taiwan, 14,33 three in Germany, 23,34,35 one in New Zealand, 36 three in Sweden, [37][38][39] two in China, 40,41 one in France, 42 three in Canada, [43][44][45] one in Mexico, 24 two in Saudi Arabia, 46,47 one in Israel, 48 one in the Republic of Korea 49 and one in Finland. 50 Studies were conducted in patients undergoing abdominal, cardiac, thoracic, orthopedic, or urologic surgery ( Table 1).…”

“…51 Twenty-six (90%) studies were placebo-controlled blinded studies. 14,[23][24][25][26][27][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][45][46][47][48][49] Primary outcomes…”

“…23,25,34,43,44 The data from the studies reporting medians could not be included in the pooled analyses. One study 27 31 evaluated pain 24 hr after the surgery during rest and activity together and therefore was not included in our analyses.…”

“…Thirteen studies assessed the incidence of postoperative nausea or vomiting 25,[31][32][33][34]37,38,40,[43][44][45][46][47] (Table 3). Pooled results showed that the incidence was significantly lower in patients who received IVLI (25%) than in those who did not (35%) (12 studies, n = 617, RR: 0.71, 95% CI 0.57-0.90; I 2 = 0%).…”