Impact of intravenous lidocaine on myocardial injury after off-pump coronary artery surgery

Lee, E.-H.; Lee, Hwa-Mi; Chung, Cheol Hyun; Chin, Ji-Hyun; Choi, Dae Ki; Chung, Hyemoon; Sim, Ji Hoon; Choi, In‐Cheol

doi:10.1093/bja/aeq416

Cited by 30 publications

(21 citation statements)

References 31 publications

(17 reference statements)

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“…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 . 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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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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“…The lidocaine infusion was terminated either at skin closure or the end of the surgical procedure [45,186,188,[190][191][192][193][194][195][196][197][198][199][200][201][202][203][204][205][206]; 1 h after surgery/skin closure [207][208][209][210][211][212]; 1 h after arrival in the post anaesthesia care unit (PACU) [213]; 4 h post-operatively [214]; up to 8 h post-operatively (or at PACU discharge whichever occurred earlier) [187]; after a total of 12 h [215]; 24 h post-operatively [216][217][218][219][220][221][222][223]; 48 h post-operatively [215,[224][225][226]; or on the day of return of bowel function or, at the latest, on the fifth post-operative day [189]. One study did not report the cessation time for the lidocaine infusion [227].…”

Section: Role Of Ivlt In Acute Perioperative 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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“…Some studies have suggested that using inhalational anesthetic agents for OPCAB might decrease myocardial injury and accelerate recovery of myocardial contractility (49,50). On the other hand, many different types of total intravenous (IV) anesthesia medication, including propofol, have been utilized for OPCAB surgery (48,(51)(52)(53). Lee and his associates (51) demonstrated that continuous IV infusion of lidocaine during OP-CAB surgery could reduce myocardial injury.…”

Section: Anesthetic Technique and Perioperative Challenges Of Opcabmentioning

confidence: 99%

On- or Off-Pump Coronary Artery Bypass: What Is the Evidence?

Sun¹,

Peng²

2016

J Anesth Perioper Med

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Impact of intravenous lidocaine on myocardial injury after off-pump coronary artery surgery

Abstract: Continuous i.v. infusion of lidocaine during surgery reduces myocardial injury in patients undergoing OPCAB.

Cited by 30 publications

References 31 publications

Continuous Lidocaine Infusion as Adjunctive Analgesia in Intensive Care Unit Patients

Continuous Lidocaine Infusion as Adjunctive Analgesia in Intensive Care Unit Patients

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

On- or Off-Pump Coronary Artery Bypass: What Is the Evidence?

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