Systemic lidocaine decreases the Bispectral Index in the presence of midazolam, but not its absence

Gottschalk, Antje; McKay, Allannah M.; Malik, Zahra M.; Forbes, Michael S.; Durieux, Marcel E.; Groves, Danja S.

doi:10.1016/j.jclinane.2011.06.018

Cited by 13 publications

(2 citation statements)

References 16 publications

(23 reference statements)

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“…Also, Gottschalk et al . reported that IV lidocaine decreases BIS only in the presence of midazolam, suggesting that the effect of lidocaine on BIS results from modulation by midazolam and not by a direct effect exerted by lidocaine [10]. In our study opioids and other depressants were omitted in order to minimize the effects of other drugs on BIS values and have a more clear picture about the effects of lidocaine on BIS.…”

Section: Discussionmentioning

confidence: 98%

Intravenous lidocaine does not affect the anesthetic depth during rapid sequence induction and intubation as assessed by Bispectral Index monitoring: a randomized double blind study

Staikou¹,

Paraskeva²,

Karmaniolou³

et al. 2013

aoms

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IntroductionWe investigated the impact of intravenous lidocaine on anesthetic depth, as assessed by Bispectral Index score (BIS), and hemodynamic responses to rapid sequence induction/intubation.Material and methodsEighty-four surgical patients with risk factors for regurgitation/aspiration were randomized to receive either lidocaine 1.5 mg/kg or normal saline in a double-blind fashion. Propofol 2 mg/kg, lidocaine or normal saline, followed by rocuronium 1 mg/kg were administered intravenously and trachea was intubated under cricoid pressure application. The BIS scores were recorded before induction of anesthesia, immediately after, at 30 s and 1 min after rocuronium injection and every 30 s after intubation, for 10 min. Systolic/diastolic blood pressure and heart rate were measured before induction, immediately after and at 1 min following rocuronium administration, and every minute for 10 min after intubation.ResultsData from 78 patients were analyzed. Demograpic characteristics did not differ between the study groups. A total of 24 BIS scores were recorded for each patient. No difference was found in BIS values between lidocaine and control groups at any time point (F = 2.936, p = 0.91). Also no difference was detected in heart rate, systolic and diastolic blood pressure at any time point of the study period between the two groups (F = 0.063, p = 0.80, F = 0.007, p = 0.93, F = 0.435, p = 0.51 respectively). No episodes of significant bradycardia occurred and none of the patients reported awareness/recall of the procedure.ConclusionsLidocaine 1.5 mg/kg given intravenously during rapid sequence induction does not affect BIS values, or blunt the hemodymanic response to laryngoscopy and intubation.

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Section: Discussionmentioning

confidence: 98%

Intravenous lidocaine does not affect the anesthetic depth during rapid sequence induction and intubation as assessed by Bispectral Index monitoring: a randomized double blind study

Staikou¹,

Paraskeva²,

Karmaniolou³

et al. 2013

aoms

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“…Intravenous lidocaine has analgesic and antihyperalgesic properties via sodium channel and NMDA receptor blockade, potentiation of GABA receptors, and mechanosensitive nociceptors (Kundra and Vinayagam 2020;Gottschalk et al 2012;Koppert et al 2000). Further, lidocaine has antinociceptive properties in the presence of surgical stimulation via modulation of synaptic transmission at the spinal dorsal horn.…”

Section: Discussionmentioning

confidence: 99%

Intravenous lidocaine reduces perioperative opioids without negatively affecting the electrical stapedial reflex threshold in pediatric cochlear implants

Bakhet

Fiky

Debis³

2021

Ain-Shams J Anesthesiol

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Background Total intravenous anesthesia (TIVA) with propofol and remifentanil is frequently used for pediatric cochlear implants (CIs) surgery as it does not suppress the electrical stapedial reflex threshold (ESRT). However, high doses of remifentanil exacerbate postoperative pain and increase opioid consumption. Intravenous lidocaine reduces pain and opioid requirement. This study investigated the effect of intravenous lidocaine on perioperative opioid consumption and ESRT in pediatric CIs. Results The mean (95% CI) remifentanil consumption was significantly lower in lidocaine group than in placebo group [0.57 (0.497–0.643) vs 0.69 (0.63–0.75)] μg/kg/min, P = 0.016. The mean (95% CI) propofol consumption was significantly lower in lidocaine group than in placebo group [155.5 (146–165) vs 171 (161–181) μg/kg/min, P = 0.02. MBP and HR were significantly lower after surgical incision, laryngeal mask airway (LMA) removal, and at PACU admission in the lidocaine group compared with the placebo group. The PACU pain score was significantly lower in the lidocaine group compared to the placebo group. The mean (95% CI) pethidine consumption in PACU was significantly lower in the lidocaine group than in the placebo group 7.0 (6.17–7.83) vs. 8.9 (7.84–9.96) mg, P = 0.012. There were no differences between groups regarding ESRT response. Conclusions Intravenous lidocaine infusion reduced perioperative opioid requirements without altering the ESRT in pediatric CIs. Trial registration Clinical registration number: NCT04194294.

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Anesthesiology and Intraoperative Electrophysiological Monitoring

Sloan

Kaye

2013

Principles of Neurophysiological Assessment, Mapping, and Monitoring

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Systemic lidocaine decreases the Bispectral Index in the presence of midazolam, but not its absence

Cited by 13 publications

References 16 publications

Intravenous lidocaine does not affect the anesthetic depth during rapid sequence induction and intubation as assessed by Bispectral Index monitoring: a randomized double blind study

Intravenous lidocaine does not affect the anesthetic depth during rapid sequence induction and intubation as assessed by Bispectral Index monitoring: a randomized double blind study

Intravenous lidocaine reduces perioperative opioids without negatively affecting the electrical stapedial reflex threshold in pediatric cochlear implants

Anesthesiology and Intraoperative Electrophysiological Monitoring

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