Intravenous lidocaine has no impact on rocuronium‐induced neuromuscular block. Randomised study

Abstract

Background: Intravenous lidocaine is increasingly used in surgical patients. As it has neuromuscular blocking effects, we tested the impact of an intravenous lidocaine infusion on the time course of a rocuronium-induced neuromuscular block. Methods: Fifty-two adults undergoing surgery were randomly allocated to intravenous lidocaine 1.5 mg/kg followed by a continuous infusion of 2 mg/kg/h or physiological saline (control) throughout surgery. Anaesthesia was induced and maintained with a target-controlled propofol infusion and sufentanil. After loss of consciousness, rocuronium 0.6 mg/kg was given. Neuromuscular transmission was measured using train-offour (TOF)-watch SX (Organon, Swords Co., Dublin, Ireland) acceleromyography. Results: Onset time (to 95% depression of first twitch) was on average 113.9 s (standard deviation 35.3) with lidocaine and 119.5 s (44.9) with saline (P = 0.618). Total recovery time (TOF ratio 0.9) was on average 58.1 min (15.1) with lidocaine and

Residual neuromuscular block in type II diabetes mellitus after rocuronium

“…Our control group had a DURTOF 90 consistent with that reported by other studies, considering mean age, anaesthetic procedure and rocuronium dose used. [11][12][13][14][15][16][17][18][19][20] Our results are also in agreement with Saitoh in the significantly longer times to reappearance of T1, T2, T3 and T4 in diabetic patients. 4-6 Saitoh also found a significantly lower TOF ratio at 120 min in the diabetic group.…”

Lidocaine alone or combined with Magnesium Sulfate stabilizes hemodynamic parameters during General Anesthesia without prolonging the Neuromuscular Blockade: a randomized, double-blind, controlled trial

“…[21][22][23][24] However, more recently, studies evaluating the clinical effects of lidocaine on neuromuscular blocking actions of cisatracurium and rocuronium have demonstrated no changes in NMB recovery characteristics or speed of onset periods. [25][26][27] Corroborating these observations, in the present study, lidocaine infusion, even in higher doses, did not result in any additional effects of magnesium sulfate alone on NMB and effectively prevented MAP and HR uctuations during anesthesia induction and maintenance. Importantly, this hemodynamic stability is particularly relevant in speci c conditions, such as in intracranial aneurysm management.…”

“…44,45 However, the use of doses and lidocaine as high as 5 mg.kg.h − 1 infused for 6 hours is reported without adverse effects. 46 Typically, lidocaine dose used in studies assessing its impact on NMB [25][26][27] has been between 1.5 and 2 mg.kg − 1 (bolus) and 2 mg.kg − 1 .h − 1 (maintenance) and results similar to ours were obtained in these studies. Although lidocaine is widely used and is especially useful as an adjuvant during general anesthesia for its analgesic and opioid-sparing effects, few studies have systematically assessed the incidence of adverse effects or optimal dose.…”

“…24 More recent studies evaluating the clinical effects of lidocaine, in lower dosage, on the neuromuscular blocking drugs cisatracurium and rocuronium have demonstrated no changes in recovery of NMB characteristics or speed of onset. [25][26][27] Considering the growing perioperative clinical applications of both lidocaine and magnesium sulfate, the possibility of using these drugs in combination increases. A combination of these drugs may not only be bene cial for surgical patients regarding opioid-sparing effects but may also in uence NMB characteristics and promote changes in hemodynamic parameters.…”

“…Considering that studies have shown that lidocaine infusion does not affect NMB, we tested the hypothesis that combined use of lidocaine with magnesium sulfate does not affect cisatracuriuminduced NMB compared with magnesium sulfate infusion alone. [25][26][27]…”