Intravenous lidocaine infusion

Soto, German; González, Molly; Calero, F.

doi:10.1016/j.redare.2018.01.015

Cited by 19 publications

(19 citation statements)

References 43 publications

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“…Clinically, Nakhli et al [35] found intravenous lidocaine infusion permitted a reduction of volatile anesthesia and IO opioid consumption during renal surgery, so it could provide effective strategy especially in low-and middleincome countries. Also, Soto et al [36] reported that perioperative lidocaine infusion may be a useful analgesic adjunct in enhanced recovery protocols due to its immuno-modulatory properties over surgical stress and so suggested its use in the context of multimodal analgesia.…”

Section: Discussionmentioning

confidence: 99%

Opioid-Free Anesthesia for Laparoscopic Hysterectomy: Is it Appropriate?

Salem

2019

JAICM

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Opioids are frequently associated with adverse events such as dizziness, drowsiness [7], high incidence of PO nausea and vomiting, which varies from 20%-60% [8] or constipation which disturbs PO recovery and extends the duration of hospital stay [7].With increased awareness of both short-and longterm problems associated with liberal perioperative opioid administration, the need for routinely and clinically feasible alternatives is greater than ever [9]. Implementation of multimodal analgesic regimen achieved equivalent and effective pain control aiming to reduce the reliance on opioid-based medications [10]. The application of enhanced recovery pathways promoted opioid-free and multimodal analgesia [11] and allowedAbstract Objective: To evaluate intraoperative (IO) and postoperative (PO) outcome of women assigned to laparoscopic hysterectomy under opioidfree anesthesia (OFA) in comparison to opioid-based anesthesia (OBA).Patient and Methods: 72 women were randomly divided into OBA and OFA groups according to the provided IO analgesic regimen. OBA patients received Fentanyl (FEN) as loading and Remifentanyl (REM) infusion as maintenance analgesia. OFA patients received preoperative parecoxib sodium for preparation, dexmedetomidine (DEX) and lidocaine (LID) as loading and maintenance analgesia. Study Outcomes included the frequency of patients developed IO deviated mean arterial pressure (MAP) measures by >20% of baseline measures, duration of surgery and time till fulfilling criteria for PACU discharge, duration of PO analgesia, time till 1st ambulation, PO complications and hospital stay.Results: Demographic data and surgical characteristics were comparable in all groups. The D group showed delay in onset for first call for analgesia (900±60.9min) while M and K groups results were (600±33.4min) and (350±17.4min) respectively, all of the group's results were statistically significant than the control group result (260±14.3min).Results: MAP measures during and 30-min after abdominal insufflations were significantly higher in patients of OFA than patients of OBA. Among 216 MAP readings, increased MAP measures by >20% of baseline measure was recorded in 10 (4.6%) versus 3 (1.4%) readings in OFA and OBA groups, respectively with a non-significant difference (p=0.091) between both groups. Duration till 1st ambulation was significantly shorter with OFA compared to OBA, while duration till 1st request of rescue analgesia was significantly longer with OFA, while the frequency of patients requested more rescue analgesia was significantly higher with OBA than OFA. PONV was reported in 53 patients and 17 patients required anti-emetic therapy with significantly higher incidence with OBA compared to OFA group. Conclusion:The applied protocol for OFA provided satisfactory IO analgesia and control of surgery-induced pressor reflexes. Also, it allowed reduction of PO analgesic consumption with early ambulation and reduced PONV that were reflected as shorter PO hospital stay.

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Section: Discussionmentioning

confidence: 99%

Opioid-Free Anesthesia for Laparoscopic Hysterectomy: Is it Appropriate?

Salem

2019

JAICM

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“…With the strategies such as ultrasound-guided technique, limitation of total drug dose, and co-application of vessel constrictors, the incidence of LAST seems to have decreased to a clinically non-important level, but is by no means unignorable ( Gitman and Barrington, 2018 ) ( Macfarlane et al, 2021 ) In addition, it is now more and more popular to use intravenous local anesthetics for intra-operative analgesia and chronic pain control ( Vanstone and Rockett, 2016 ; Weibel et al, 2016 ; Song et al, 2017 ; Farahmand et al, 2018 ; Soto et al, 2018 ; Clivio et al, 2019 ), however, it may increase the incidence of LAST, because plasm drug concentration would increase more rapidly than local application ( Gitman et al, 2019 ; Torp and Simon, 2020 ). A fundamental method to increase the safety of local anesthetics is to ensure that even if all drugs applied are accidentally injected into the circulation system, there could be a margin wide enough from the actual plasma concentration to the concentration responsible for the earliest toxicities.…”

Section: Discussionmentioning

confidence: 99%

Lido-OH, a Hydroxyl Derivative of Lidocaine, Produced a Similar Local Anesthesia Profile as Lidocaine With Reduced Systemic Toxicities

Yin

Zhang

et al. 2021

Front. Pharmacol.

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Background: lidocaine is one of the most commonly used local anesthetics for the treatment of pain and arrhythmia. However, it could cause systemic toxicities when plasma concentration is raised. To reduce lidocaine’s toxicity, we designed a hydroxyl derivative of lidocaine (lido-OH), and its local anesthesia effects and systemic toxicity in vivo were quantitively investigated.Method: the effectiveness for lido-OH was studied using mouse tail nerve block, rat dorsal subcutaneous infiltration, and rat sciatic nerve block models. The systemic toxicities for lido-OH were evaluated with altered state of consciousness (ASC), arrhythmia, and death in mice. Lidocaine and saline were used as positive and negative control, respectively. The dose-effect relationships were analyzed.Results: the half effective-concentration for lido-OH were 2.1 mg/ml with 95% confident interval (CI95) 1.6–3.1 (lidocaine: 3.1 mg/ml with CI95 2.6–4.3) in tail nerve block, 8.2 mg/ml with CI95 8.0–9.4 (lidocaine: 6.9 mg/ml, CI95 6.8–7.1) in sciatic nerve block, and 5.9 mg/ml with CI95 5.8–6.0 (lidocaine: 3.1 mg/ml, CI95 2.4–4.0) in dorsal subcutaneous anesthesia, respectively. The magnitude and duration of lido-OH were similar with lidocaine. The half effective doses (ED50) of lido-OH for ACS was 45.4 mg/kg with CI95 41.6–48.3 (lidocaine: 3.1 mg/kg, CI95 1.9–2.9), for arrhythmia was 16.0 mg/kg with CI95 15.4–16.8 (lidocaine: 3.0 mg/kg, CI95 2.7–3.3), and for death was 99.4 mg/kg with CI95 75.7–124.1 (lidocaine: 23.1 mg/kg, CI95 22.8–23.4). The therapeutic index for lido-OH and lidocaine were 35.5 and 5.6, respectively.Conclusion: compared with lidocaine, lido-OH produced local anesthesia at similar potency and efficacy, but with significantly reduced systemic toxicities.

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“…Lidocaine has been discussed extensively in literature for its use as a local anesthetic agent in surgical procedures [ 12 , 13 ]. Its role as a systemic analgesic agent has been controversial with relatively few studies examining its intraoperative use for the goal of achieving effective term postoperative pain control [ [6] , [7] , [8] , [9] , [10] , 14 ]. This meta-analysis was performed to determine the effect of intraoperative intravenous lidocaine on postoperative opiate consumption in patients undergoing spinal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Lidocaine, also known as xylocaine or lignocaine, is now a commonly used local anesthetic agent included by the World Health Organization on its list of essential medicines [ 2 , 5 ]. Given its analgesic, anti-hyperalgesic, and anti-inflammatory properties in addition to immunomodulation capabilities related to surgical stress, lidocaine has been proposed as a component of multi-modal analgesia [6] , [7] , [8] , [9] , [10] , [11] .…”

Section: Introductionmentioning

confidence: 99%

Intravenous lidocaine in spine surgery: A meta-analysis of randomized controlled trials

Haratian

Musa

Field

et al. 2021

North American Spine Society Journal (NASSJ)

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Intravenous lidocaine infusion

Cited by 19 publications

References 43 publications

Opioid-Free Anesthesia for Laparoscopic Hysterectomy: Is it Appropriate?

Opioid-Free Anesthesia for Laparoscopic Hysterectomy: Is it Appropriate?

Lido-OH, a Hydroxyl Derivative of Lidocaine, Produced a Similar Local Anesthesia Profile as Lidocaine With Reduced Systemic Toxicities

Intravenous lidocaine in spine surgery: A meta-analysis of randomized controlled trials

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