Perioperative Use of Intravenous Lidocaine

Dunn, Lauren K.; Durieux, Marcel E.

doi:10.1097/aln.0000000000001527

Cited by 298 publications

(228 citation statements)

References 48 publications

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“…Intravenous lidocaine could be an effective adjuvant analgesic in older postoperative critically ill patients, which may be with severe pain, in whom high doses of opioids can decrease respiratory drive and consequently, increase mechanical ventilation requirements [2]. In addition, intravenous lidocaine infusion is a promising alternative when neuraxial analgesia is contraindicated.…”

Section: Resultsmentioning

confidence: 99%

“…We present the case of a septic older patient after urgent abdominal surgery, exceedingly sensitive to opioid adverse effects, in which continuous intravenous lidocaine infusion allowed excellent and enhanced recovery [2].…”

Section: Background and Objectivesmentioning

confidence: 99%

“…It is time dependent and reversible. However, there is no evidence of benefit with intravenous lidocaine infusion over 24 hours [2], though in enhanced recovery protocols following colorectal surgery may be applied till postoperative day 23.…”

Section: Background and Objectivesmentioning

confidence: 99%

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Continuous Intravenous Lidocaine Infusion: Effective Analgesic Choice in a Complex Critically Ill Patient

Duque¹,

Piñeiro²

2017

J Clin Case Rep

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The need to manage acute pain in older patients is becoming increasingly frequent in postoperative intensive care units. Older population is extremely sensitive to opioid adverse effects. Therefore, intravenous infusion of lidocaine might be a useful tool in this scenario. We present the case of an ICU older patient after urgent abdominal surgery. Pain management with opioid therapy was extremely complex with serious adverse effects. Intravenous lidocaine infusion not only proved to be effective but also allowed an enhanced postoperative recovery.

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Section: Resultsmentioning

confidence: 99%

Section: Background and Objectivesmentioning

confidence: 99%

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Continuous Intravenous Lidocaine Infusion: Effective Analgesic Choice in a Complex Critically Ill Patient

Duque¹,

Piñeiro²

2017

J Clin Case Rep

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“…By allowing the control of the gag reflex, it minimizes the consequences of the massive catecholamines realease and reduces the perioperative risk [4]. Lidocaine has also antiinflamatory and analgesic activities [6,7].…”

Section: Discussionmentioning

confidence: 99%

“…It is well known, the lidocaine role on hemodynamic stability, using 1-1.5 mg/Kg intravenously before laryngoscopy [2,4,6]. By allowing the control of the gag reflex, it minimizes the consequences of the massive catecholamines realease and reduces the perioperative risk [4].…”

Section: Discussionmentioning

confidence: 99%

Lidocaine: A Key-Factor to Avoid the Postponement of an Oncologic Urgent Surgery

Varandas¹,

Rodrigues²,

Saraiva³

et al. 2017

J Anesth Clin Res

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Intravenous Lidocaine for Gut Function Recovery in Colonic Surgery

Paterson,

Vadiveloo,

Innes

et al. 2024

JAMA

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ImportanceDespite the recovery advantages of minimally invasive surgical techniques, delayed return of gut function after colectomy is a common barrier to timely discharge from hospital.ObjectiveTo evaluate the effect of 2% perioperative intravenous lidocaine infusion on return of gut function after elective minimally invasive colon resection.Design, Setting, and ParticipantsThe ALLEGRO trial was a randomized, placebo-controlled, double-blind trial conducted in 27 UK hospitals. A total of 590 adults scheduled for elective minimally invasive colon resection for benign or malignant disease were randomized 1:1 to 2% intravenous lidocaine or saline placebo. Enrollment occurred from August 13, 2018, to April 11, 2023, with a pause in recruitment from March 20, 2020, through July 6, 2020; final follow-up was on August 10, 2023.InterventionsThe intervention patients received 2% intravenous lidocaine administered as 1.5-mg/kg bolus at induction of anesthesia followed by 1.5 mg/kg/h for 6 or 12 hours. Control patients received 0.9% saline placebo for 6 or 12 hours.Main Outcomes and MeasuresThe primary outcome was the proportion of patients with return of gut function at 72 hours after surgery, defined by the GI-3 composite end point of tolerating diet (ingestion of food and drink without significant nausea or vomiting for 3 consecutive meals) and passage of flatus or stool. There were 11 secondary outcomes, including time to GI-3 recovery, time to GI-2 recovery (tolerance of oral diet and passage of stool), prolonged postoperative ileus, postoperative nausea and vomiting score, Overall Benefit of Analgesia Score, postoperative opioid consumption, Quality of Recovery–15, quality of life (EuroQol 5-Dimension 5-Level), enhanced recovery protocol adherence, time to meeting medically defined criteria for discharge, and time to patient self-assessed readiness for discharge.ResultsThe trial enrolled 590 patients (295 intervention, 295 control); after 33 postrandomization exclusions, 557 patients were included (279 intervention, 278 control; 249 female patients [44.7%]; mean [SD] age, 66 [10.9] years); 532 (96%) received the randomized treatment. Return of gut function as defined by the GI-3 composite outcome was achieved at 72 hours by 160 patients (57.3%) in the intravenous lidocaine group vs 164 patients (59.0%) in the placebo group (adjusted absolute difference, −1.9% [95% CI, −8.0% to 4.2%]; relative risk, 0.97 [95% CI, 0.88 to 1.07]). There was no significant difference between the intervention and control groups in any of the 11 secondary end points.Conclusions and RelevanceAmong patients undergoing elective minimally invasive colon resection, perioperative administration of 2% intravenous lidocaine did not improve return of gut function at 72 hours.Trial Registrationisrctn.org Identifier: ISRCTN52352431

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Perioperative Use of Intravenous Lidocaine

Cited by 298 publications

References 48 publications

Continuous Intravenous Lidocaine Infusion: Effective Analgesic Choice in a Complex Critically Ill Patient

Continuous Intravenous Lidocaine Infusion: Effective Analgesic Choice in a Complex Critically Ill Patient

Lidocaine: A Key-Factor to Avoid the Postponement of an Oncologic Urgent Surgery

Intravenous Lidocaine for Gut Function Recovery in Colonic Surgery

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