Effect of Perioperative Intravenous Lidocaine Infusion on Acute and Chronic Pain after Breast Surgery: A Meta‐Analysis of Randomized Controlled Trials

Chang, Yuan‐Ching; Liu, Chien‐Liang; Liu, Tsang-Pai; Yang, Po‐Sheng; Chen, Ming‐Jen; Cheng, Shih‐Ping

doi:10.1111/papr.12442

Cited by 58 publications

(40 citation statements)

References 39 publications

(55 reference statements)

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“…A recent meta-analysis performed by Chang et al examines the effect of intravenous lidocaine on acute and chronic pain after breast surgery. Their results are consistent with previous studies: there is no beneficial effect of lidocaine for the treatment of acute pain, but it decreases the risk of the development of post-surgical chronic pain ( 41 ).…”

Section: Evidence Acquisitionsupporting

confidence: 93%

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The Efficacy of Systemic Lidocaine in the Management of Chronic Pain: A Literature Review

Yousefshahi¹,

Predescu²,

Asenjo³

2017

Anesth Pain Med

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ContextDespite recent advances in the understanding of the chronic pain concept, its diagnosis and management remains a daily challenge for clinicians and patients. Based on the published literature, this review discusses and tries to organize the current knowledge and the up-to-date clinical experience about the efficacy and safety of the use of intravenous lidocaine in treatment and prevention of chronic pain.Evidence AcquisitionTo prepare this narrative review, we performed an in depth literature review using the PubMed searching engine. We extracted all relevant articles published in English, up to April 2016.ResultsLidocaine, administered as transdermal patch or intravenous lidocaine, is a safe and effective modality in the treatment of post-herpetic neuralgia (PHN), complex regional pain syndrome, as well and for prevention of chronic pain. It may be effective in the management of neuropathic pain syndromes, chronic pain, post-operative pain, and refractory cancer pain.ConclusionsIntravenous lidocaine and lidocaine patch are effective and safe for the treatment of several chronic or neuropathic pain syndromes. The use of lidocaine during surgery could prevent the development of some chronic post-surgical pain syndromes.

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Section: Evidence Acquisitionsupporting

confidence: 93%

“…Lidocaine seems to be effective when administered intraperitoneally ( 46 , 48 ), or via epidural ( 43 , 45 ). As mentioned, not all the studies prove the efficiency of lidocaine on reducing immediate postoperative pain ( 39 , 41 ).…”

Section: Evidence Acquisitionmentioning

confidence: 99%

The Efficacy of Systemic Lidocaine in the Management of Chronic Pain: A Literature Review

Yousefshahi¹,

Predescu²,

Asenjo³

2017

Anesth Pain Med

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“…Nonetheless, the evidence evaluating the safety and effectiveness of IVLI therapy for acute pain in ICU patients is very limited. In most recent years several systematic reviews of the use of perioperative IVLI for pain have been published, including a Cochrane review in which 45 randomized controlled trials with a total of 2802 participants were thoroughly analyzed . Among all these trials, however, only a handful of studies included ICU patients and attempted to assess ICU‐related outcomes .…”

Section: Discussionmentioning

confidence: 99%

“…In most recent years several systematic reviews of the use of perioperative IVLI for pain have been published, including a Cochrane review in which 45 randomized controlled trials with a total of 2802 participants were thoroughly analyzed. [18][19][20] Among all these trials, however, only a handful of studies included ICU patients and attempted to assess ICU-related outcomes. 16,[21][22][23][24] Furthermore, ICU patients with organ dysfunctions such as decreased cardiac output, kidney dysfunction, or hepatic impairment were not examined in detail in these studies.…”

Section: Discussionmentioning

confidence: 99%

Continuous Lidocaine Infusion as Adjunctive Analgesia in Intensive Care Unit Patients

Thomas

Antigua

et al. 2017

The Journal of Clinical Pharmacology

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Despite a paucity of data, the role of intravenous lidocaine (IVLI) as adjunctive analgesia in the intensive care unit (ICU) seems promising due to a low potential to contribute to respiratory depression. A retrospective chart review was conducted to evaluate the safety and effectiveness of IVLI for the treatment of pain in ICU patient with varying degrees of organ dysfunction from March 2014 to March 2016. The primary outcomes included the time to a ≥ 20 % reduction in pain scores after the initiation of IVLI and the difference in opioid requirements as well as pain scores prior to and during IVLI therapy. Other variables included the presence of IVLI-related adverse events and the dosage and duration of IVLI. A total of 21 ICU patients were included from two different hospitals. The mean time to a ≥ 20 % reduction in pain scores from the start of IVLI was 3.3 hours (SD = 2.2). The median morphine dose equivalents required during 6, 12, and 24 hours pre-IVLI were significantly higher compared to the same time periods after IVLI (18.3 vs. 10 mg, p=0.002; 41.8 vs. 18.3 mg, p=0.002; 93.5 vs. 30.5 mg, p=0.037). Neurological adverse effects of lidocaine were noted in 3 patients, but the effects were reversed upon IVLI discontinuation. This report suggested that IVLI as an adjunctive agent in the treatment of acute pain may be a potential option in ICU patients who are refractory to opioids or those in whom opioid-induced respiratory depression is a concern.

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“…Perioperative use of IV lidocaine can have a beneficial effect as a prophylactic measure to prevent the development of chronic pain. For breast cancer patients, perioperative IV lidocaine was effective in reducing the severity of persistent postsurgical pain at 3 months [76,77] and mastectomy patients had 20 times less the relative risk of the occurrence of postsurgical chronic pain when compared with placebo [78]. Similarly, patients undergoing complex spine surgery had overall lower opioid consumption and improved quality of life with administration of perioperative IV lidocaine [79].…”

Section: Intravenous Lidocainementioning

confidence: 99%

State of the art opioid-sparing strategies for post-operative pain in adult surgical patients

Gabriel

Swisher

Sztain

et al. 2019

Expert Opinion on Pharmacotherapy

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Introduction: There are various important implications associated with poorly controlled postoperative pain in the adult surgical patientthis includes cardiopulmonary complications, opioid-related side effects, unplanned hospital admissions, prolonged hospital stay, and the subsequent development of chronic pain or opioid addiction. With the ongoing national opioid crisis, it is imperative that perioperative providers implement pathways for surgical patients that reduce opioid requirements and painrelated complications. Areas covered: In this review, the authors discuss the components of a multimodal opioid-sparing analgesia pathway as it pertains to the perioperative environment. Medications reviewed include gabapentinoids, acetaminophen, non-steroidal anti-inflammatory drugs, ketamine, intravenous lidocaine, dexmedetomidine, and glucocorticoids. The use of peripheral nerve blocks and neuraxial analgesia are also discussed. Expert opinion: In appropriate cases, regional anesthetic interventions are extremely useful for postoperative analgesia, including peripheral nerve blocks and neuraxial analgesia and while newer postoperative analgesics have been postulated, the literature on such is presently controversial. Coordinated approaches to pain management are recommended to reduce the need for opioids and to improve patient satisfaction post-surgery.

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Effect of Perioperative Intravenous Lidocaine Infusion on Acute and Chronic Pain after Breast Surgery: A Meta‐Analysis of Randomized Controlled Trials

Cited by 58 publications

References 39 publications

The Efficacy of Systemic Lidocaine in the Management of Chronic Pain: A Literature Review

The Efficacy of Systemic Lidocaine in the Management of Chronic Pain: A Literature Review

Continuous Lidocaine Infusion as Adjunctive Analgesia in Intensive Care Unit Patients

State of the art opioid-sparing strategies for post-operative pain in adult surgical patients

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