The <i>in vitro</i> mechanisms and <i>in vivo</i> efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain

Wal, Selina E I van der; Heuvel, Sandra A S van den; Radema, Sandra A.; Berkum, B F M van; Vaneker, Michiel; Steegers, Monique A H; Scheffer, Gert-Jan; Vissers, Kris

doi:10.1002/ejp.794

Cited by 108 publications

(67 citation statements)

References 117 publications

(146 reference statements)

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“…Recent work has suggested that intravenous infusions of lidocaine may be beneficial especially in abdominal surgery due to its analgesic, antihyperalgesic, and anti-inflammatory effects. 36 There is evidence to suggest that lidocaine infusions decrease post-operative pain, reduce the use of opioids, facilitate the recovery of gut function and shorten the duration of hospital stay. 37 However, the optimal dose of lidocaine and duration of infusion is yet to be established and there remains concern regarding the safety of lidocaine infusions in clinical practice.…”

Section: Intravenous Lidocainementioning

confidence: 99%

Enhanced recovery after surgery: Pain management

Nimmo

Foo

Paterson

2017

Journal of Surgical Oncology

129

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Effective pain management is fundamental to enhanced recovery after surgery. Selection of strategies should be tailored to patient and operation. As well as improving the quality of recovery, effective analgesia reduces the host stress response, facilitates mobilization and allows resumption of oral intake. Multi-modal regimens combining paracetamol, non-steroidal anti-inflammatory agents where indicated, a potent opioid and a local anaesthetic technique achieve effective analgesia while limiting the dose and thereby side effects of any one agent.

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Section: Intravenous Lidocainementioning

confidence: 99%

Enhanced recovery after surgery: Pain management

Nimmo

Foo

Paterson

2017

Journal of Surgical Oncology

129

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“…This drug has peripheral and central actions, which reduces neural responses to pain. Animal studies show that systemic lidocaine alters conduction in neurons of the dorsal horn, dorsal root ganglion and hyperexcitable neuromas without producing nerve conduction block [20]. In vitro, a low dose of lidocaine inhibits voltage-gated sodium channels (VGSC), the glycinergic system, some potassium channels and G-protein coupled receptors, while the higher-voltage-gated calcium channels, NMDA receptors and other potassium channels [21].…”

Section: Discussionmentioning

confidence: 99%

Lidocaine as an element of multimodal analgesic therapy in major spine surgical procedures in children: a prospective, randomized, double-blind study

et al. 2020

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Background Introducing the principles of multimodal analgesic therapy is necessary to provide appropriate comfort for the patient after surgery. The main objective of the study was evaluating the influence of perioperative intravenous (i.v.) lidocaine infusion on postoperative morphine requirements during the first 48 h postoperatively in children undergoing major spine surgery. Materials and methods Prospective, randomized, double-blind study: 41 children, qualified to multilevel spine surgery, were randomly divided into two treatment groups: lidocaine and placebo (control). The lidocaine group received lidocaine as a bolus of 1.5 mg/kg over 30 minutes, followed by a continuous infusion at 1 mg/kg/h to 6 hours after surgery. The protocol of perioperative management was identical for all patients. Measurements: morphine demand, intensity of postoperative pain (the Numerical Rating Scale), oral feeding initiation time, first attempts at assuming erect position, postoperative quality of life (the Acute Short-form /SF-12/ health survey). Results Patient data did not differ demographically. Compared to the control group, lidocaine treatment reduced the demand for morphine during the first 24h [95% CI 0.13 (0.11-0.28) mg/kg, p = 0.0122], 48h [95% CI 0.46 (0.22-0.52) mg/kg, p = 0.0299] after surgery and entire hospitalization [95% CI 0.58 (0.19-0.78) mg/kg, p = 0.04]; postoperative pain intensity; nutritional withdrawal period [introduction of liquid diet (p = 0.024) and solid diet (p = 0.012)], and accelerated the adoption of an upright position [sitting (p = 0.048); walking (p = 0.049)]. The SF-12 generic health survey did not differ between groups before operation, 2 months and 4 years after surgery. Conclusions Perioperative lidocaine administration, as a part of the applied analgesic therapy regimen, may decrease postoperative opioid demand and accelerates convalescence of children undergoing major surgery.

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“…The exact lidocaine plasma level and duration of infusion required to produce this effect are unknown; however, it occurs at levels below those required for action potential initiation and propagation for neural blockade. It is also not known if plasma lidocaine concentration correlates with analgesic effect in a dose dependent manner as different channels and receptors are modulated at different plasma lidocaine concentrations [145].…”

Section: The Rationale For Ivlt In the Management Of Painmentioning

confidence: 99%

“…In vitro, low dose lidocaine inhibits voltage-gated sodium channels (VGSC), some potassium channels, the glycinergic system, and G-protein coupled receptors. Higher dose lidocaine blocks voltage-gated calcium channels, other potassium channels, and NMDA receptors [145,149,150]. Lidocaine dosages needed for voltage-gated sodium channel blockade range from 60 to 200 μM, whereas voltage-gated calcium channel blockade occurs at higher doses in the 1-10 mM range [6, [151][152][153].…”

Section: The Rationale For Ivlt In the Management Of Painmentioning

confidence: 99%

A Review of Intravenous Lidocaine Infusion Therapy for Paediatric Acute and Chronic Pain Management

Lauder¹

2017

Pain Relief - From Analgesics to Alternative Therapies

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Pediatric acute and chronic pain experiences involve the interaction of physiological, psychological, behavioural, developmental, pharmacological and situational factors. In the acute perioperative pain setting preventative multimodal analgesia is required to provide comfort and minimise the potential for "wind-up" and central sensitisation. When pain is recurrent, ongoing or chronic some children embark on a downward spiral of decreased physical, psychological and social functioning. The multidisciplinary team management approach is a well-established standard of care for children with complex chronic pain. Intravenous lidocaine has peripheral and central mediated analgesic, anti-inflammatory and anti-hyperalgesic properties. Intravenous lidocaine infusion therapy (IVLT) has been shown to be effective in the management of acute and chronic pain in adults. This chapter will present the rational for IVLT in pediatric pain management with emphasis on preventative multimodal therapy in acute pain and the multidisciplinary treatment approach in chronic pain. Large multi-centre randomised controlled trials are required to provide the evidence-base to confirm that IVLT is indeed an effective and safe treatment option in acute preventative multimodal analgesia and as an adjunct in the multidisciplinary care of chronic pain in the pediatric population. Keywords

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The in vitro mechanisms and in vivo efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain

Abstract: Intravenous lidocaine has analgesic, anti-inflammatory and antihyperalgesic properties mediated by an inhibitory effect on ion channels and receptors. It attenuates the neuroinflammatory response in perioperative pain and chronic neuropathic pain.

Cited by 108 publications

References 117 publications

Enhanced recovery after surgery: Pain management

Enhanced recovery after surgery: Pain management

Lidocaine as an element of multimodal analgesic therapy in major spine surgical procedures in children: a prospective, randomized, double-blind study

A Review of Intravenous Lidocaine Infusion Therapy for Paediatric Acute and Chronic Pain Management

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