Use of Lidocaine for Pain Management in the Emergency Medicine: A Systematic Review and Meta-Analysis

Abstract

Background: Lidocaine is a well-known medium-acting local anesthetic with a short onset time. It is a valuable drug for managing both acute and chronic pains and is being used as a popular agent for pain control in the emergency department (ED). In this systematic review, we intended to define the effectiveness of lidocaine in pain management of the patients referring to ED. Methods: The preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement was utilized for this Systematic Review (SR). We searched the databases of PubMed, Scopus, ProQuest, and Medline (Ovid) from 1990 to August 2017 for Randomized Controlled Trials (RCTs) in which the study population was referred to the emergency department and received lidocaine. Full-texts of the studies that were published in English were reviewed for inclusion. Both authors individualistically evaluated all studies. Seven articles were eligible for the meta-analysis based on their common outcomes. Results: The total number of subjects was 671. The studies were categorized based on the type of drug and administration route. Mean pain, regardless of the drug administration method, in the placebo group was 0.69 units higher than the lidocaine group. Considering the administration route, mean pain in the placebo group was 0.35 units higher than the lidocaine group when administered topically, and it was lower in the subcutaneous method than the topical method by 1.41 units. Conclusion: Infiltration of lidocaine decreases pain of different procedures in the ED whereas the effect of topical lidocaine is controversial issue.

Effects of Oropharyngeal Lidocaine Spray Before Endotracheal Intubation on Heart Rate, Blood Pressure, and Arrhythmia in Patients Undergoing Coronary Artery Bypass Grafting Surgery: A Randomized Clinical Trial

“…Lidocaine as a medium-acting agent is used to relieve pain, and its short onset of action makes it the drug of choice in many emergency conditions. 8 Previous studies have failed to find drugs that could improve hemodynamic stability during rapid intubation. 9 This study aimed to investigate the effect of oropharyngeal LS before tracheal intubation on HR, BP, and arrhythmia in patients undergoing heart surgery.…”

Bibliometric Analysis of Anesthetic Drugs’ Effects on Immune Function- Current Knowledge, Hotspots and Future Perspectives

“…Although lidocaine infiltration lowers the discomfort of several emergency department treatments, the impact of topical lidocaine is controversial. 37 At the same time, local anesthetics have the ability to impede numerous immunocompetent cell functions, including the suppression of NK cell activity, hindering chemotaxis, adhesion, phagocytosis, and respiratory burst of granulocytes. The incubation of NK cells with whole blood cells containing local anesthetics such as lidocaine, bupivacaine, and ropivacaine results in a significant inhibition of NK cell activity.…”

Comparison of the Effectiveness of EMLA Cream, 2% Lidocaine Gel, and Ice Bag on Pain Intensity Caused by Venipuncture in Children Aged 6-12 Years

“…Lidocaine is a local anesthetic drug with a moderate effect and a short onset of action, which blocks the transmission of nerve messages in acute and chronic pain by inhibiting voltage-dependent sodium ion channels [11]. In this regard, the results of Ravanshad et al showed that the use of lidocaine gel has been associated with a reduction in pain during hemodialysis venipuncture in children [12].…”