Systemic Lidocaine Decreased the Perioperative Opioid Analgesic Requirements but Failed to Reduce Discharge Time After Ambulatory Surgery

McKay, Allannah M.; Gottschalk, Antje; Ploppa, Annette; Durieux, Marcel E.; Groves, Danja S.

doi:10.1213/ane.0b013e3181be371b

Cited by 92 publications

(51 citation statements)

References 12 publications

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“…Kaba et al found that the total dose of sufentanil given to patients in the lidocaine group during laparoscopic colectomy was significantly lower than in the control group (13.0 ± 3.7 µg versus 16.3 ± 3.6 µg) [7]. A similar result was obtained in ambulatory surgery where lidocaine use yielded a 30% reduction in intraoperative opioid use [31]. In another study, in patients undergoing laparoscopic cholecystectomy, the total fentanyl consumption was found to be significantly lower in the lidocaine group (242 ± 48.5 µg vs 323 ± 70.8 µg) [32].…”

Section: Discussionmentioning

confidence: 81%

“…This observation is particularly important for patients with severe coronary artery disease. The protocol of administering a loading dose followed by a continuous IV infusion of lidocaine during general anesthesia has been used in several previous investigations [7,10,11,31,33]. The doses used are calculated to achieve a plasma lidocaine concentration well below the toxic levels (> 5 µg/ml) [7,21].…”

Section: Discussionmentioning

confidence: 99%

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Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Nakhli

Kahloul

Guizani

et al. 2018

Libyan Journal of Medicine

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The role of intraoperative intravenous lidocaine infusion has been previously evaluated for pain relief, inflammatory response, and post-operative recovery, particularly in abdominal surgery. The present study is a randomized double-blinded trial in which we evaluated whether IV lidocaine infusion reduces isoflurane requirement, intraoperative remifentanil consumption and time to post-operative recovery in non-laparoscopic renal surgery. Sixty patients scheduled to undergo elective non-laparoscopic renal surgery under general anesthesia were enrolled to receive either systemic lidocaine infusion (group L: bolus 1.5 mg/kg followed by a continuous infusion at the rate of 2 mg/kg/hr until skin closure) or normal saline (0.9% NaCl solution) (Group C). The depth of anesthesia was monitored using the Bispectral Index Scale (BIS), which is based on measurement of the patient’s cerebral electrical activity. Primary outcome of the study was End-tidal of isoflurane concentration (Et-Iso) at BIS values of 40–60. Secondary outcomes include remifentanil consumption during the operation and time to extubation. Et-Iso was significantly lower in group L than in group C (0.63% ± 0.10% vs 0.92% ± 0.11%, p < 10–3). Mean remifentanil consumption of was significantly lower in group L than in group C (0.13 ± 0.04 µg/kg/min vs 0.18 ± 0.04 µg/kg/min, p < 10–3). Thus, IV lidocaine infusion permits a reduction of 31% in isoflurane concentration requirement and 27% in the intraoperative remifentanil need. In addition, recovery from anesthesia and extubation time was shorter in group L (5.8 ± 1.8 min vs 7.9 ± 2.0 min, p < 10–3). By reducing significantly isoflurane and remifentanil requirements during renal surgery, intravenous lidocaine could provide effective strategy to limit volatile agent and intraoperative opioids consumption especially in low and middle income countries.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Nakhli

Kahloul

Guizani

et al. 2018

Libyan Journal of Medicine

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“…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).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…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…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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

Vigneault

Turgeon

Côté

et al. 2010

Can J Anesth/J Can Anesth

333

227

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Introduction 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. Methods A systematic search was performed using MED-LINE, EMBASE, Cochrane, and SCOPUS databases, likewise, grey literature. The review included all randomized controlled trials that used a placebo or any comparator and evaluated IVLI during general anesthesia for any type of surgery. Primary outcomes were pain control and opioid requirement. Secondary outcomes were mortality, length of stay, ileus recovery time, nausea/vomiting, and adverse events. Random effects models were used and heterogeneity was assessed using the I 2 index. to -5.56), time to first flatus (WMD -7.62 hr, 95% CI -10.78 to -4.45), time to first feces (WMD -10.71 hr, 95% CI -16.14 to -5.28), nausea/vomiting (risk ratios = 0.71, 95% CI 0.57-0.90), and hospital length of stay (WMD -0.17 days, 95% CI -0.41 to 0.07). Abdominal surgery was strongly associated with benefit. For the 12 studies that systematically screened adverse events, the Results 123Can J Anesth/J Can Anesth (2011) 58:22-37 DOI 10.1007/s12630-010-9407-0 incidence of cardiac and neurologic adverse events was comparable. Eight studies observed toxic plasma levels. Discussion 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. RésuméIntroduction Plusieurs strate´gies ont e´te´propose´es pour le contrôle de la douleur postope´ratoire. Parmi ces strate´gies, la lidocaı¨ne par voie intraveineuse suscite un inte´reˆt croissant. Toutefois, ses avantages cliniques demeurent peu clairs. Cette revue me´thodique est une e´valuation de l'efficaciteá nalge´sique et de l'innocuite´de la lidocaı¨ne par voie intraveineuse pendant l'anesthe´sie ge´ne´rale. Méthode Une recherche me´thodique a e´te´re´alise´e dans les bases de donne´es MEDLINE, EMBASE, Cochrane et SCOPUS ainsi que dans la litte´rature grise. Cette revue a tenu compte de toutes les e´tudes randomise´es contrôle´es ayant utilise´un placebo ou un traitement de re´fe´rence et e´value´la lidocaı¨ne par voie intraveineuse pendant l'anesthe´sie ge´ne´rale, quel que soit le type de chirurgie. Les principaux crite`res d'e´valuation e´taient le contrôle de la douleur et le besoin en opioı¨des. Les crite`res d'e´valuation secondaires e´taient la mortalite´, la dure´e d'hospitalisation, le temps de re´cupe´ration du transit intestinal, les nause´es et vomissements et les e´ve´nements inde´sirables. Des mode`les a`effets ale´atoires ont e´teú tilise´s e...

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Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery

Kranke

Jokinen

Pace

et al. 2015

Cochrane Database of Systematic Reviews

236

218

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Systemic Lidocaine Decreased the Perioperative Opioid Analgesic Requirements but Failed to Reduce Discharge Time After Ambulatory Surgery

Abstract: Perioperative systemic lidocaine significantly reduces opioid requirements in the ambulatory setting without affecting time to discharge.

Cited by 92 publications

References 12 publications

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

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

Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery

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