The Effect of a Bolus Dose of Intravenous Lidocaine on the Minimum Alveolar Concentration of Sevoflurane

Hamp, Thomas; Krammel, Mario; Schmid, Rainer; Gráf, Alexandra; Plöchl, Walter

doi:10.1213/ane.0b013e318294820f

Cited by 26 publications

(21 citation statements)

References 35 publications

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“…The use of IV lignocaine has been shown to be associated with a reduced requirement of intravenous anaesthetic agents, specifically propofol [12–15]. Intravenous lignocaine has also been shown to reduce the requirements of volatile anaesthetics in patients undergoing non-abdominal surgeries [16–18], findings similar to the present study. Interestingly, even the delivery of lignocaine via both the epidural and IV routes has been shown to reduce requirement of volatile anaesthetics [19, 20].…”

Section: Discussionsupporting

confidence: 84%

“…In laparoscopic abdominal surgery, IV lignocaine has reduced the average concentration of volatile anaesthetic agents by more than 35% [21, 22]. However, to our knowledge, in the context of major open abdominal surgery only two studies have evaluated the effects of IV lignocaine on the concentration of volatile anaesthetic required to maintain anaesthesia [16, 20]. Hamp et al found that the mean alveolar concentration of sevoflurane was 12% lower in those receiving a bolus dose of 1.5 mg/kg of intravenous lignocaine [13, 16].…”

Section: Discussionmentioning

confidence: 99%

“…However, to our knowledge, in the context of major open abdominal surgery only two studies have evaluated the effects of IV lignocaine on the concentration of volatile anaesthetic required to maintain anaesthesia [16, 20]. Hamp et al found that the mean alveolar concentration of sevoflurane was 12% lower in those receiving a bolus dose of 1.5 mg/kg of intravenous lignocaine [13, 16]. Kuo et al administered 2 mg/kg bolus of IV lignocaine followed by an infusion of intravenous lignocaine (3 mg/kg/h), and reported that the mean ET-Sevo concentration was 18% lower in the Lignocaine group [20].…”

Section: Discussionmentioning

confidence: 99%

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The effects of intravenous lignocaine on depth of anaesthesia and intraoperative haemodynamics during open radical prostatectomy

et al. 2017

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BackgroundLignocaine is a local anaesthetic agent, which is also commonly used as a perioperative analgesic adjunct to accelerate rehabilitation and enhance recovery after surgery. Lignocaine’s systemic effects on intraoperative haemodynamics and volatile anaesthetic requirements are not well explored. Therefore, we evaluated the effects of intravenous lignocaine on intraoperative volatile agent requirements and haemodynamics in patients undergoing major abdominal surgery.MethodsWe performed an analysis of 76 participants who underwent elective open radical retropubic prostatectomy. Patients received lignocaine (1.5 mg/kg loading dose) followed by an infusion (1.5 mg/kg/h) for the duration of surgery, or saline at an equivalent rate. The aims of the study were to evaluate the end-tidal sevoflurane concentration required to maintain a bispectral index of between 40 and 60. Measurements included intraoperative blood pressure, heart rate, and the volume of intravenous fluids and dosage of vasoactive medications administered.ResultsThe average end-tidal sevoflurane concentration was lower in the Lignocaine group compared to saline [1.49% (SD: 0.32) vs. 1.89% (SD: 0.29); 95% CI 0.26–0.5, p < 0.001]. In the Lignocaine group, the average mean arterial pressure was 80.3 mmHg (SD: 4.9) compared to 85.1 mmHg (SD: 5.4) in the Saline group (95% CI 2.4–7.1, p < 0.001). Systolic blood pressure was also lower in the Lignocaine group: 121.7 mmHg (SD: 6.1) vs. 128.0 mmHg (SD: 6.4) in the Saline group; 95% CI 3.5–9.2, p < 0.001, as was the mean heart rate [Lignocaine group: 74.9 beats/min (SD: 1.8) vs. 81.5 beats/min (SD: 1.7) in the Saline group, 95% CI 4.1–9.1, p < 0.001]. Maintenance fluid requirements were higher in the Lignocaine group: 3281.1 mL (SD: 1094.6) vs. 2552.6 mL (SD: 1173.5) in the Saline group, 95% CI 206–1251, p = 0.007. There were no differences in the use of vasoactive drugs.ConclusionsIntravenous lignocaine reduces volatile anaesthetic requirements and lowers blood pressure and heart rate in patients undergoing open radical prostatectomy.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The effects of intravenous lignocaine on depth of anaesthesia and intraoperative haemodynamics during open radical prostatectomy

et al. 2017

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“…Sevoflurane requirement was significantly reduced during abdominal surgery as monitored by BIS at all intraoperative time points [11]. The same result was found in different types of surgeries using sevoflurane [7,11,32,34] and desflurane [6,22,27]. Similarly, systemic lidocaine allowed Altermatt et al to reduce propofol requirement during the maintenance of total intravenous anesthesia for laparoscopic cholecystectomy as measured by BIS.…”

Section: Discussionmentioning

confidence: 70%

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Nakhli

Kahloul

Guizani

et al. 2018

Libyan Journal of Medicine

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The role of intraoperative intravenous lidocaine infusion has been previously evaluated for pain relief, inflammatory response, and post-operative recovery, particularly in abdominal surgery. The present study is a randomized double-blinded trial in which we evaluated whether IV lidocaine infusion reduces isoflurane requirement, intraoperative remifentanil consumption and time to post-operative recovery in non-laparoscopic renal surgery. Sixty patients scheduled to undergo elective non-laparoscopic renal surgery under general anesthesia were enrolled to receive either systemic lidocaine infusion (group L: bolus 1.5 mg/kg followed by a continuous infusion at the rate of 2 mg/kg/hr until skin closure) or normal saline (0.9% NaCl solution) (Group C). The depth of anesthesia was monitored using the Bispectral Index Scale (BIS), which is based on measurement of the patient’s cerebral electrical activity. Primary outcome of the study was End-tidal of isoflurane concentration (Et-Iso) at BIS values of 40–60. Secondary outcomes include remifentanil consumption during the operation and time to extubation. Et-Iso was significantly lower in group L than in group C (0.63% ± 0.10% vs 0.92% ± 0.11%, p < 10–3). Mean remifentanil consumption of was significantly lower in group L than in group C (0.13 ± 0.04 µg/kg/min vs 0.18 ± 0.04 µg/kg/min, p < 10–3). Thus, IV lidocaine infusion permits a reduction of 31% in isoflurane concentration requirement and 27% in the intraoperative remifentanil need. In addition, recovery from anesthesia and extubation time was shorter in group L (5.8 ± 1.8 min vs 7.9 ± 2.0 min, p < 10–3). By reducing significantly isoflurane and remifentanil requirements during renal surgery, intravenous lidocaine could provide effective strategy to limit volatile agent and intraoperative opioids consumption especially in low and middle income countries.

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“…Intravenous lidocaine increases the depth of anesthesia of propofol and of sevoflurane [66,67]. Perioperative administered lidocaine intravenous as a bolus or as a continuous infusion and for local or regional anesthesia reduces pain before, during, and after operations and procedures [43,[68][69][70].…”

Section: Intravenous and Topical Lidocainementioning

confidence: 99%

Adult and pediatric anesthesia/sedation for gastrointestinal procedures outside of the operating room

Er¹

2015

Current Opinion in Anaesthesiology

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Both anesthesiologists and nonanesthesiologists have to achieve a consensus and develop quality-improvement strategies to provide safe and efficient anesthesia and sedation for gastrointestinal procedures outside of the operating room for pediatric and adult patients. Techniques using TIVA, TCI, intravenous or topical application of lidocaine, and the video laryngoscope may improve and facilitate gastrointestinal procedures for the patients, the anesthesiologists, and the gastroenterologists.

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The Effect of a Bolus Dose of Intravenous Lidocaine on the Minimum Alveolar Concentration of Sevoflurane

Abstract: IV 1.5 mg·kg(-1) lidocaine decreased the MAC by at least 0.03% sevoflurane (mean difference 0.23% sevoflurane [95% adjusted CI, 0.03-0.43]). We did not observe a significant reduction in the MAC of sevoflurane with the IV administration of 0.75 mg·kg(-1) lidocaine.

Cited by 26 publications

References 35 publications

The effects of intravenous lignocaine on depth of anaesthesia and intraoperative haemodynamics during open radical prostatectomy

The effects of intravenous lignocaine on depth of anaesthesia and intraoperative haemodynamics during open radical prostatectomy

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Adult and pediatric anesthesia/sedation for gastrointestinal procedures outside of the operating room

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