Lidocaine Infusion as a Rescue Analgesic in the Perioperative Setting

Clarke, Collin; McConachie, Ian; Banner, Robert

doi:10.1155/2008/768231

Cited by 12 publications

(8 citation statements)

References 18 publications

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“…The analgesic effect produced by lidocaine has been well recognised in several clinical and experimental models. Lidocaine attenuates neuropathic pain in rodents [ 41 ], produces thermal antinociception in horses [ 42 ], and provides perioperative analgesia in humans [ 43 ] and dogs [ 44 ]. Several mechanisms have been proposed to elucidate the analgesic effects of lidocaine and may be found elsewhere [ 45 ].…”

Section: Resultsmentioning

confidence: 99%

Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

et al. 2013

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BackgroundTumescent anaesthesia (TA) is a widely used technique in oncologic surgeries necessitating large resection margins. This technique produces transoperative and postoperative analgesia, reduces surgical bleeding, and facilitates tissue divulsion. This prospective, randomised, blind study evaluated the use of TA in bitches submitted to mastectomy and compared the effect of TA with an intravenous fentanyl bolus. A 2.5-mcg/kg intravenous fentanyl bolus (n = 10) was compared with TA using 0.275% lidocaine (n = 10) in bitches submitted to unilateral mastectomy. Sedation was performed by intramuscular (IM) injection of 0.05 mg/kg of acepromazine combined with 2 mg/kg of meperidine. Anaesthesia was induced with 5 mg/kg of intravenous propofol and maintained with isoflurane/O2. Heart and respiratory rates; systolic, mean, and diastolic arterial blood pressures; central venous pressure; SpO2; ETCO2; inspired and expired isoflurane concentrations; and temperature were measured transoperatively. Visual analogue scales for sedation and pain and the Glasgow composite and Melbourne pain scales were used for postoperative assessment. The surgeon investigated the quality of the surgical approach, considering bleeding and resection ability, and the incidence of postoperative wound complications.ResultsThe heart rate was lower and the end-tidal isoflurane concentration was higher in dogs treated with fentanyl than in dogs treated with TA. A fentanyl bolus was administered to 8 of 10 dogs treated with fentanyl and to none treated with TA. Intraoperative bleeding and the mammary gland excision time were lower in dogs treated with TA. The maximal mean and individual plasma lidocaine concentrations were 1426 ± 502 ng/ml and 2443 ng/ml at 90 minutes after infiltration, respectively. The Glasgow Composite Pain Scale scores were higher in dogs treated with fentanyl than in dogs treated with TA until 2 hours after extubation.ConclusionsCompared with intravenous fentanyl, TA in bitches: may be easily performed in non-inflamed, ulcerated, adhered mammary tumours; has an isoflurane-sparing effect; improves transoperative and immediate postoperative analgesia; is apparently safe for use in clinical conditions as evidenced by the fact that it did not produce any adverse signs or lidocaine plasma concentrations compatible with toxicity; does not modify the recovery time; and facilitates the surgical procedure without interfering with wound healing.

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Section: Resultsmentioning

confidence: 99%

Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

et al. 2013

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“…It can lead to better postoperative analgesia, reduced opioid consumption and improved intestinal motility [ 40 ]. In addition to the analgesic action, local anesthetics have anti-inflammatory action, justifying also the use of intravenous lidocaine to modulate the inflammatory response resulting from postoperative pain [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction

et al. 2020

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Background Breast surgery in the United States is common. Pain affects up to 50% of women undergoing breast surgery and can interfere with postoperative outcomes. General anesthesia is the conventional, most frequently used anaesthetic technique. Various locoregional anesthetic techniques are also used for breast surgeries. A systematic review of the use of locoregional anesthesia for postoperative pain in breast surgery is needed to clarify its role in pain management. Objectives To systematically review literature to establish the efficacy and the safety of locoregional anesthesia used in the treatment of pain after breast surgery. Methods Embase, MEDLINE, Google Scholar and Cochrane Central Trials Register were systematically searched in Mars 2020 for studies examining locoregional anesthesia for management of pain in adults after breast surgery. The methodological quality of the studies and their results were appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and specific measurement properties criteria, respectively. Results Nineteen studies evaluating locoregional anesthesia were included: 1058 patients underwent lumpectomy/mastectomy, 142 breast augmentation and 79 breast reduction. Locoregional anesthesia provides effective anesthesia and analgesia in the perioperative setting, however no statistically significant difference emerged if compared to other techniques. For mastectomy only, the use of locoregional techniques reduces pain in the first hour after the end of the surgery if compared to other procedures (p = 0.02). Other potentially beneficial effects of locoregional anesthesia include decreased need for opioids, decreased postoperative nausea and vomiting, fewer complications and increased patient satisfaction. All this improves postoperative recovery and shortens hospitalization stay. In none of these cases, locoregional anesthesia was statistically superior to other techniques. Conclusion The results of our review showed no differences between locoregional anesthesia and other techniques in the management of breast surgery. Locoregional techniques are superior in reducing pain in the first hour after mastectomy.

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“…Possibly not, because lidocaine-induced analgesia goes beyond the half-life of such metabolites. Intravenous lidocaine has been used in different surgical procedures 1,12,27 . When intravenously administered, it is initially distributed to richly perfused organs, such as skin, skeletal muscle and fat.…”

Section: Pharmacological Aspects Of Intrave-nous Lidocainementioning

confidence: 99%

“…When serum levels go beyond 5µg/mL symptoms are variable and severity depends on lidocaine blood concentration 25 (Table 2). With regard to CNS, seizure might be the first indication of severe intoxication 26 and may be caused by the inhibition of inhibitory neurons through GABA receptors (gamma-aminobutyric acid) in the amygdala 25,27 . In general, there is seizure with plasma concentrations above 8µg/mL but it may be seen with lower serum levels in the presence of hypercarbia 23 .…”

Section: Intravenous Lidocaine Adverse Effects and Contraindicationsmentioning

confidence: 99%

Intravenous lidocaine to treat postoperative pain

Couceiro¹,

Lima

Couceiro³

et al. 2014

Revista Dor

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BACKGROUND AND OBJECTIVES: Postoperative pain is foreseeable however it is still undermanaged. Multimodal management decreases side-effects and provides adequate pain control. Lidocaine, local anesthetic used for more than five decades, is being intravenously administered aiming at managing pain in different types of surgeries with promising results. This study aimed at reviewing the use of intravenous lidocaine to manage postoperative pain, and its action mechanism. CONTENTS: This article addresses the use of intravenous lidocaine to manage postoperative pain, its action mechanism and its applicability for different types of surgeries. An active search was carried out in the following databases: Medline via Pubmed (1974-2013), Cochrane Library (1990-2010) and LILACS (1974-2013). Search was adjusted to identify articles addressing postoperative intravenous lidocaine action mechanism and postoperative analgesia. As to language, articles in Portuguese and English were selected. CONCLUSION: Intravenous lidocaine, due to its low cost, opioid-sparing action and minimum side-effects is an adequate option to manage postoperative pain.

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Lidocaine Infusion as a Rescue Analgesic in the Perioperative Setting

Cited by 12 publications

References 18 publications

Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction

Intravenous lidocaine to treat postoperative pain

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