Mecanismos envolvidos na analgesia da lidocaína por via venosa

Lauretti, Gabriela Rocha

doi:10.1590/s0034-70942008000300011

Cited by 108 publications

(26 citation statements)

References 48 publications

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“…Because the mild adverse effects begin with serum levels above 3 g mL −1 , this dose results in a safety pharmacology window for the use of intravenous lidocaine. 19,20 Therefore, studies that stipulate the beginning of IL infusion in relation to the surgical incision time, duration of infusion in the postoperative period, and the total dose of intravenous lidocaine to be administered are required to define its actual role in postoperative analgesia in women undergoing mastectomy.…”

Section: Discussionmentioning

confidence: 99%

Intravenous lidocaine for postmastectomy pain treatment: randomized, blind, placebo controlled clinical trial

Couceiro¹,

Lima

Burle³

et al. 2015

Brazilian Journal of Anesthesiology (English Edition)

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Section: Discussionmentioning

confidence: 99%

Intravenous lidocaine for postmastectomy pain treatment: randomized, blind, placebo controlled clinical trial

Couceiro¹,

Lima

Burle³

et al. 2015

Brazilian Journal of Anesthesiology (English Edition)

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“…14,41 The central hyperalgesia, on the other hand, is related to sodium channels located at the ends of mechanoreceptors, in the spinal cord, and in dorsal root ganglia. 12 The blocking of such sodium channels cause inhibition of the spontaneous and evoked neuronal activity and reduces the neuronal hyperactivity, with greater pain relief and for a longer time, compared with that related to the drug's pharmacokinetic patterns. Lidocaine also promotes the reduction of allodynia and hyperalgesia.…”

Section: Central Painmentioning

confidence: 99%

“…9 In addition to its well established anesthetic and antiarrhythmic actions, intravenous lidocaine also has significant anti-inflammatory properties, by inhibiting the release of cytokines and interfering with the action of inflammatory cells, such as macrophages, monocytes and polymorphonuclear cells. 9,12,42 This latter form of action is being currently tested in several studies and seems very promising.…”

Section: Central Painmentioning

confidence: 99%

“…6,11 However, other mechanisms are also involved in the analgesia provided by lidocaine 9,12 as, for instance, the interaction, whether direct or indirect, with different receptors and pathways of nociceptive transmission, like the muscarinic agonists, glicine inhibitors, release of endogenous opioids and of adenosine triphosphate, and the reduced production of excitatory amino acids, neurokinins and thromboxane A2. 12 Although lidocaine is typically administered through local injections, it is also used intravenously for various purposes, such as regional anesthesia, as an anti-dysrhythmic agent, in the relief of peripheral and central neuropathic pain, 13,14 fibromyalgia treatment 15 and as an adjuvant in postoperative pain, 9 among others.…”

Section: Introductionmentioning

confidence: 99%

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The analgesic effect of intravenous lidocaine in the treatment of chronic pain: a literature review

Souza

Kraychete

2014

Revista Brasileira de Reumatologia (English Edition)

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RBRE-73; No. of Pages 7 r e v b r a s r e u m a t o l . 2 0 1 4;x x x(x x):xxx-xxx REVISTA BRASILEIRA DE REUMATOLOGIA w w w . r e u m a t o l o g i a . c o m . b r Available online xxx Keywords: Lidocaine Intravenous lidocaine Chronic pain a b s t r a c tBackground: pain is a public health problem, greatly impairing quality of life. Almost 80% of patients with chronic pain reported that their pain interferes with activities of daily living, and two thirds reported that the pain causes negative impact on their personal relationships.The physical and functional disability, whether temporary or permanent, compromises the professional activity and causes work absenteeism, increasing costs of health systems.Objectives: the aim of this review is to analyze, based on the literature, the analgesic effect of lidocaine administered intravenously for the treatment of chronic pain and to evaluate the reduction of pain intensity in patients with chronic pain, focusing on musculoskeletal and neuropathic etiology. Methodology: the method used was a review of the literature, consisting in searching the scientific literature on the efficacy of intravenous lidocaine infusion in the treatment of patients with chronic pain. Content: of the 19 studies reviewed, 12 had results that confirm the analgesic effect of intravenous lidocaine in patients with chronic pain. Most authors used doses of 5 mg/kg infused for 30 minutes or more, producing significant analgesia with variable duration (minutes to weeks). Conclusions: based on the literature review, it is not possible to uniformly specify the most effective and safe dose of lidocaine administered intravenously for the treatment of neuropathic or musculoskeletal pain. As for effectiveness, the intravenous infusion of lidocaine as an alternative for the treatment of chronic pain of various etiologies seems very promising, but further studies need to be conducted. 2 r e v b r a s r e u m a t o l . 2 0 1 4;x x x(x x):xxx-xxx A ação analgésica da lidocaína intravenosa no tratamento da dor crônica: uma revisão de literatura Palavras-chave: Lidocaína Lidocaína intravenosa Dor crônica r e s u m o Justificativa: a dor é um problema de saúde pública, comprometendo sobremaneira a qualidade de vida. Quase 80% dos pacientes com dor crônica relataram que a dor interfere em suas atividades da vida diária, e dois terços afirmaram que a dor provoca impacto negativo nas relaç ões pessoais. A incapacidade física e funcional, seja temporária ou permanente, compromete a atividade profissional e causa absenteísmo ao trabalho, elevando os custos dos sistemas de saúde. Objetivos: o objetivo desta revisão é analisar, com base na literatura, o efeito analgésico da lidocaína administrada por via intravenosa no tratamento da dor crônica e avaliar a redução da intensidade da dor em pacientes com dor crônica, focando a etiologia musculoesquelética e neuropática. Metodologia: o método adotado foi o de revisão da literatura, consistindo na busca de artigos científicos sobre a eficácia da infusão intravenosa de lidoca...

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“…O uso sistêmico da lidocaína como analgésico transoperatório fica restrito à administração por IC e quando associada ao propofol produz redução de 18% na taxa mí-nima infusão do anestésico [13,14]. A IC de cetamina promoveu redução significativa na dose de infusão propofol, aumentou a frequência cardíaca e a pressão arterial média e produziu depressão respiratória mais acentuada do que quando comparado com a IC de propofol isolado [9,11].…”

Section: Introductionunclassified

Total Intravenous Anesthesia with Propofol Associated with Fentanyl, Lidocaine or Ketamine in Bitches Submitted to Elective Ovariohysterectomy

Monzem

Spiller

Dower

et al. 2017

Acta Scientiae. Vet.

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Background: Total intravenous anesthesia with propofol is an alternative to inhalation anesthesia because it offers smoother anesthetic recovery, however, since propofol does not have adequate analgesic action, it is necessary to associate it with some drug to avoid the pain process. In addition, the combination may minimize cardiovascular depression resulting from continuous infusion of propofol by reducing infusion rate. The aim of this study was to evaluate cardiorespiratory parameters and anesthetic recovery in bitches submitted to continuous infusion of fentanyl, lidocaine and ketamine associated with total intravenous anesthesia with propofol and submitted to elective ovariohisterectomy.Materials, Methods & Results: Twenty-four bitches were medicated intramuscularly with 0.03 mg/kg of acepromazine. After 30 min, they were divided into three groups with different analgesic treatments: group F (GF) received a loading dose (LD) of 0.0036 mg/kg fentanyl, followed by continuous infusion of 0.0036 mg/kg/h; group L (GL), LD of 3 mg/kg lidocaine, followed by 3 mg/kg/h and group K (GK), LD of 0.6 mg/kg ketamine, followed by 0.6 mg/kg/h. First a LD of analgesic treatment was administered, followed by induction (to the effect) and beginning of continuous infusion of the analgesic treatment and propofol. The animals were intubated with endotracheal tube of adequate size, and connected to 100% oxygen, being kept under spontaneous ventilation during the entire period of anesthetic maintenance. The infusion of propofol started at 0.34 mg/kg/min and was adjusted so as to maintain the surgical anesthesia plane of Guedel and the cardiovascular parameters within the physiological limits for the species. The cardiorespiratory parameters were measured at different moments: basal (before application of any drug) and 5, 15, 20, 30, 40, 50, 60, 70 and 80 min after induction. The surgery started 20 min after anesthetic induction and lasted 60 min. At the end of the surgery, infusions were terminated and anesthesia recovery was evaluated by measuring the extubation time, sternal decubitus, and quadrupedal position in min. A variance analysis was performed to compare means of cardiorespiratory parameters for the moments and groups followed by the Scott-knott test. Differences were considered significant when P < 0.05. The baseline parameters, age, weight and dose of propofol IC were not statistically different between groups. The infusion rate of propofol increased in all groups from M5 to M15. GF and GL presented lower values for heart rate and GK presented higher values for the same variable. Blood pressure decreased after induction and increased in M40, M50 and M60. The variables EtCo2, PaCo2 and HCO3 increased and pH decreased showing respiratory depression in all groups. The mean time, in min, for orotracheal extubation, sternal decubitus and quadrupedal position were respectively 5 ± 3, 20 ± 6 and 39 ± 13 for GF; 6 ± 2, 23 ± 7 and 51 ± 15 for GL; 4 ± 2, 18 ± 6 and 42 ± 22 for GK and did not present statistical difference between the groups.Discussion: The combination of continuous infusion of fentanyl, lidocaine or ketamine to total intravenous anesthesia with propofol provides cardiovascular stability, but does not prevent respiratory function depression. The dose of propofol IC was the same in all groups, thus demonstrating that analgesics have the same potency in the transoperative period and justifies similar anesthetic recovery times. Thus, it can be concluded that these associations are feasible for total intravenous anesthesia provided proper monitorins for respiratory function.

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Mecanismos envolvidos na analgesia da lidocaína por via venosa

Cited by 108 publications

References 48 publications

Intravenous lidocaine for postmastectomy pain treatment: randomized, blind, placebo controlled clinical trial

Intravenous lidocaine for postmastectomy pain treatment: randomized, blind, placebo controlled clinical trial

The analgesic effect of intravenous lidocaine in the treatment of chronic pain: a literature review

Total Intravenous Anesthesia with Propofol Associated with Fentanyl, Lidocaine or Ketamine in Bitches Submitted to Elective Ovariohysterectomy

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