Lidocaine, old drug - new possibilities. Treatment of postoperative pain and reduction of postoperative complications with intravenous administration
DOI:
https://doi.org/10.12775/JEHS.2022.12.09.090Keywords
Intravenous lidocaine, Perioperative lidocaine, Postoperative painAbstract
Introduction: The number of surgeries requiring sedation continues to increase worldwide. Analgesia is one of the main components of anesthesia used during surgical procedures. Despite improvements in surgical techniques, the invention of new analgesics and a significant expansion of knowledge about the pathophysiology of pain, more than 75% of patients experience postoperative pain. Adequate analgesia reduces postoperative complications and shortens the length of hospitalization. Lidocaine is a local anesthetic also used as an antiarrhythmic drug. Studies report that intravenous administration may find application in perioperative analgesia.
Aim of the study: The purpose of our study was to determine in which types of surgery the benefits of IVL (Intravenous lidocaine) are greatest.
Methods and Evidence: We reviewed the literature available on PubMed using the words "Intravenous lidocaine"; "Perioperative Lidocaine "; "Postoperative pain".
Results: IVL has been shown to have a positive effect on reducing opioid doses, postoperative pain intensity, shortening the duration of postoperative bowel obstruction, faster patient rehabilitation and shortening hospitalization. In non-abdominal surgeries, the greatest benefits have been seen in breast surgery, urology and spinal surgery. Lidocaine has low toxicity; only doses several times higher cause adverse effects.
Conclusions: IVL should be used during intraabdominal surgery due to its high efficacy. Further studies on a larger group of patients are needed to better determine the effects of IVL in other surgeries.
Keywords: "Intravenous lidocaine"; "Perioperative Lidocaine "; "Postoperative pain".
References
Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe-Leitz T, Fu R, Azad T, Chao TE, Berry WR, Gawande AA. Size and distribution of the global volume of surgery in 2012. Bull World Health Organ. 2016 Mar 1;94(3):201-209F. doi: 10.2471/BLT.15.159293. PMID: 26966331; PMCID: PMC4773932.
Kehlet, Henrik. Postoperative pain, analgesia, and recovery—bedfellows that cannot be ignored. PAIN: September 2018 - Volume 159 - Issue - p S11-S16 doi: 10.1097/j.pain.0000000000001243
Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003 Aug;97(2):534-540. doi: 10.1213/01.ANE.0000068822.10113.9E. PMID: 1287394.
KuKanich, B. and Wiese, A.J. (2015). Opioids. In Veterinary Anesthesia and Analgesia (eds K.A. Grimm, L.A. Lamont, W.J. Tranquilli, S.A. Greene and S.A. Robertson). https://doi.org/10.1002/9781119421375.ch11
Kehlet H, Dahl JB. The value of "multimodal" or "balanced analgesia" in postoperative pain treatment. Anesth Analg. 1993 Nov;77(5):1048-56. doi: 10.1213/00000539-199311000-00030. PMID: 8105724.
Shim JH. Multimodal analgesia or balanced analgesia: the better choice? Korean J Anesthesiol. 2020 Oct;73(5):361-362. doi: 10.4097/kja.20505. Epub 2020 Sep 21. PMID: 32951409; PMCID: PMC7533177.
Beverly, A., Kaye, A. D., Ljungqvist, O., & Urman, R. D. (2017). Essential Elements of Multimodal Analgesia in Enhanced Recovery After Surgery (ERAS) Guidelines. Anesthesiology Clinics, 35(2), e115–e143. doi:10.1016/j.anclin.2017.01.018
Yang X, Wei X, Mu Y, Li Q, Liu J. A review of the mechanism of the central analgesic effect of lidocaine. Medicine (Baltimore). 2020 Apr;99(17):e19898. doi: 10.1097/MD.0000000000019898. PMID: 32332666; PMCID: PMC7440315.
Hamaya C, Barr T, Strichartz GR. Multiple Inhibitory Mechanisms of Lidocaine on Bradykinin Receptor Activity in Model Sensory Neurons. Reg Anesth Pain Med. 2018 Aug;43(6):605-612. doi: 10.1097/AAP.0000000000000758. PMID: 29557886.
Docherty RJ, Ginsberg L, Jadoon S, Orrell RW, Bhattacharjee A. TRPA1 insensitivity of human sural nerve axons after exposure to lidocaine. Pain. 2013 Sep;154(9):1569-1577. doi: 10.1016/j.pain.2013.04.030. Epub 2013 Apr 18. PMID: 23707266.
Hollmann MW, Wieczorek KS, Berger A, Durieux ME. Local anesthetic inhibition of G protein-coupled receptor signaling by interference with Galpha(q) protein function. Mol Pharmacol. 2001 Feb;59(2):294-301. doi: 10.1124/mol.59.2.294. PMID: 11160866.
Lin TY, Chung CY, Lu CW, Huang SK, Shieh JS, Wang SJ. Local anesthetics inhibit glutamate release from rat cerebral cortex synaptosomes. Synapse. 2013 Sep;67(9):568-79. doi: 10.1002/syn.21661. Epub 2013 Apr 2. PMID: 23468398.
Hermanns, Henning & Hollmann, Markus & Stevens, Markus & Lirk, Philipp & Brandenburger, Timo & Piegeler, Tobias & Werdehausen, Robert. (2019). Molecular mechanisms of action of systemic lidocaine in acute and chronic pain: a narrative review. British Journal of Anaesthesia. 123. 10.1016/j.bja.2019.06.014.
Beaussier, M., Delbos, A., Maurice-Szamburski, A., Ecoffey, C., & Mercadal, L. (2018). Perioperative Use of Intravenous Lidocaine. Drugs. doi:10.1007/s40265-018-0955-x
Kawamata M, Watanabe H, Nishikawa K, Takahashi T, Kozuka Y, Kawamata T, Omote K, Namiki A. Different mechanisms of development and maintenance of experimental incision-induced hyperalgesia in human skin. Anesthesiology. 2002 Sep;97(3):550-9. doi: 10.1097/00000542-200209000-00006. PMID: 12218519.
Wolfgang Koppert, Susanne Zeck, Reinhard Sittl, Rudolf Likar, Rainer Knoll, Martin Schmelz; Low-dose Lidocaine Suppresses Experimentally Induced Hyperalgesia in Humans . Anesthesiology 1998; 89:1345–1353 doi: https://doi.org/10.1097/00000542-199812000-00011
Swenson BR, Gottschalk A, Wells LT, Rowlingson JC, Thompson PW, Barclay M, Sawyer RG, Friel CM, Foley E, Durieux ME: Intravenous lidocaine is as effective as epidural bupivacaine in reducing ileus duration, hospital stay, and pain after open colon resection: A randomized clinical trial. Reg Anesth Pain Med 2010; 35:370–6
Samarin, M. J., Mohrien, K. M., & Oliphant, C. S. (2015). Continuous Intravenous Antiarrhythmic Agents in the Intensive Care Unit. Critical Care Nursing Quarterly, 38(4), 329–344. doi:10.1097/cnq.0000000000000082
VYDEN, J. K., MANDEL, W. J., HAYAKAWA, H., NAGASAWA, K., & GROSETH-DITTRICH, M. (1975). The Effect of Lidocaine on Peripheral Hemodynamics. The Journal of Clinical Pharmacology, 15(7), 506–510. doi:10.1002/j.1552-4604.1975.tb01472.x
Caracas, H. C. P. M., Maciel, J. V. B., Martins, P. M. R. e S., de Souza, M. M. G., & Maia, L. C. (2009). The use of lidocaine as an anti-inflammatory substance: A systematic review. Journal of Dentistry, 37(2), 93–97. doi:10.1016/j.jdent.2008.10.005
Eriksson AS, Sinclair R, Cassuto J, Thomsen P. Influence oflidocaine on leukocyte function in the surgical wound. Anesthesiology 1992;77:74–8.
Hattori M, Dohi S, Nozaki M, Niwa M, Shimonaka H.The inhibitory effects of local anesthetics onsuperoxide generation of neutrophils correlate with their partition coefficients. Anesthesia Analgesia 1997;84:
Gunnar Rimbäck, Jean Cassuto, Gunnar Wallin, Göran Westlander; Inhibition of Peritonitis by Amide Local Anesthetics. Anesthesiology 1988; 69:881–886 doi: https://doi.org/10.1097/00000542-198812000-00013
Chang, Herng-Yu Sucie AB*; Togias, Alkis MD†; Brown, Robert H. MD, MPH*†‡. The Effects of Systemic Lidocaine on Airway Tone and Pulmonary Function in Asthmatic Subjects. Anesthesia & Analgesia: May 2007 - Volume 104 - Issue 5 - p 1109-1115 doi: 10.1213/01.ane.0000260638.57139.87
Buchanan L, Tuma F. Postoperative Ileus. [Updated 2022 Mar 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560780/
Venara, Aurélien & Neunlist, Michel & Slim, Karem & Barbieux, J. & Colas, P.A. & Hamy, A. & Meurette, G.. (2016). Postoperative ileus: Pathophysiology, incidence, and prevention. Journal of Visceral Surgery. 153. 10.1016/j.jviscsurg.2016.08.010.
Sun Y, Li T, Wang N, Yun Y, Gan TJ: Perioperative systemic lidocaine for postoperative analgesia and recovery after abdominal surgery: A meta-analysis of randomized controlled trials. Dis Colon Rectum 2012; 55:1183–94
Vigneault L, Turgeon AF, Côté D, Lauzier F, Zarychanski R, Moore L, McIntyre LA, Nicole PC, Fergusson DA: Perioperative intravenous lidocaine infusion for postoperative pain control: A meta-analysis of randomized controlled trials. Can J Anaesth 2011; 58:22–37
McCarthy GC, Megalla SA, Habib AS: Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: A systematic review of randomized controlled trials. Drugs 2010; 70:1149–63
Marret E, Rolin M, Beaussier M, Bonnet F. Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br J Surg. 2008 Nov;95(11):1331-8. doi: 10.1002/bjs.6375. PMID: 18844267.
De Oliveira GS Jr, Duncan K, Fitzgerald P, Nader A, Gould RW, McCarthy RJ. Systemic lidocaine to improve quality of recovery after laparoscopic bariatric surgery: a randomized double-blinded placebo-controlled trial. Obes Surg. 2014 Feb;24(2):212-8. doi: 10.1007/s11695-013-1077-x. PMID: 24036842.
Grady MV, Mascha E, Sessler DI, Kurz A. The effect of perioperative intravenous lidocaine and ketamine on recovery after abdominal hysterectomy. Anesth Analg. 2012 Nov;115(5):1078-84. doi: 10.1213/ANE.0b013e3182662e01. Epub 2012 Sep 25. PMID: 23011561.
Peng X, Zhao Y, Xiao Y, Zhan L, Wang H. Effect of intravenous lidocaine on short-term pain after hysteroscopy: a randomized clinical trial. Braz J Anesthesiol. 2021 Jul-Aug;71(4):352-357. doi: 10.1016/j.bjane.2021.02.015. Epub 2021 Feb 6. PMID: 34229861; PMCID: PMC9373697.
Klinger RY, Cooter M, Bisanar T, Terrando N, Berger M, Podgoreanu MV, Stafford-Smith M, Newman MF, Mathew JP; Neurologic Outcomes Research Group of the Duke Heart Center. Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial. Anesthesiology. 2019 Jun;130(6):958-970. doi: 10.1097/ALN.0000000000002668. PMID: 30870159; PMCID: PMC6520120.
Yuksel SS, Chappell AG, Jackson BT, Wescott AB, Ellis MF. "Post Mastectomy Pain Syndrome: A Systematic Review of Prevention Modalities". JPRAS Open. 2021 Oct 30;31:32-49. doi: 10.1016/j.jpra.2021.10.009. PMID: 34926777; PMCID: PMC8651974.
Chang YC, Liu CL, Liu TP, Yang PS, Chen MJ, Cheng SP. Effect of Perioperative Intravenous Lidocaine Infusion on Acute and Chronic Pain after Breast Surgery: A Meta-Analysis of Randomized Controlled Trials. Pain Pract. 2017 Mar;17(3):336-343. doi: 10.1111/papr.12442. Epub 2016 Feb 23. PMID: 26913591.
Lauwick S, Kim DJ, Mistraletti G, Carli F. Functional walking capacity as an outcome measure of laparoscopic prostatectomy: the effect of lidocaine infusion. Br J Anaesth. 2009 Aug;103(2):213-9. doi: 10.1093/bja/aep103. Epub 2009 May 13. PMID: 19443419.
Nakhli MS, Kahloul M, Guizani T, Zedini C, Chaouch A, Naija W. Intravenous lidocaine as adjuvant to general anesthesia in renal surgery. Libyan J Med. 2018 Dec;13(1):1433418. doi: 10.1080/19932820.2018.1433418. PMID: 29433385; PMCID: PMC5814763.
Martin F, Cherif K, Gentili ME, Enel D, Abe E, Alvarez JC, Mazoit JX, Chauvin M, Bouhassira D, Fletcher D. Lack of impact of intravenous lidocaine on analgesia, functional recovery, and nociceptive pain threshold after total hip arthroplasty. Anesthesiology. 2008 Jul;109(1):118-23. doi: 10.1097/ALN.0b013e31817b5a9b. PMID: 18580181; PMCID: PMC2728117.
Bi Y, Ye Y, Ma J, Tian Z, Zhang X, Liu B. Effect of perioperative intravenous lidocaine for patients undergoing spine surgery: A meta-analysis and systematic review. Medicine (Baltimore). 2020 Nov 25;99(48):e23332. doi: 10.1097/MD.0000000000023332. PMID: 33235097; PMCID: PMC7710210.
Hashemian AM, Zamani Moghadam Doloo H, Saadatfar M, Moallem R, Moradifar M, Faramarzi R, Sharifi MD. Effects of intravenous administration of fentanyl and lidocaine on hemodynamic responses following endotracheal intubation. Am J Emerg Med. 2018 Feb;36(2):197-201. doi: 10.1016/j.ajem.2017.07.069. Epub 2017 Jul 21. PMID: 28917437.
Röhm KD, Piper SN, Schöllhorn TA, Suttner SW, Maleck WH, Boldt J. Injektionsschmerz unter Propofol-MCT/LCT und Propofol-LCT - Vergleich einer Prophylaxe mit Lidocain [Injection pain secondary to propofol-MCT/LCT and propofol-LCT--comparison of prophylaxis with lidocaine]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2003 Oct;38(10):643-7. German. doi: 10.1055/s-2003-42508. PMID: 14508703.
Ghimire B, Bahadur Chand M. Lidocaine for Reduction of Pain Induced by Propofol in a Tertiary Care Hospital: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2021 Apr 30;59(236):365-368. doi: 10.31729/jnma.5796. PMID: 34508534; PMCID: PMC8369599.
Yao W, Zhang L, Lu G, Wang J, Zhang L, Wang Y, Xiao P, Chen X, Chen C, Zhou M. Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study. BMC Anesthesiol. 2021 Dec 1;21(1):299. doi: 10.1186/s12871-021-01525-0. PMID: 34852767; PMCID: PMC8638197.
Liu H, Chen M, Lian C, Wu J, Shangguan W. Effect of intravenous administration of lidocaine on the ED50 of propofol induction dose during gastroscopy in adult patients: A randomized, controlled study. J Clin Pharm Ther. 2021 Jun;46(3):711-716. doi: 10.1111/jcpt.13335. Epub 2020 Dec 22. PMID: 33351197.
Weinberg, Laurence & Peake, Benjamin & Tan, Chong & Nikfarjam, Mehrdad. (2015). Pharmacokinetics and pharmacodynamics of lignocaine: A review. World Journal of Anesthesiology. 4. 17-29. 10.5313/wja.v4.i2.17.
Cheung HM, Lee SM, MacLeod BA, Ries CR, Schwarz SK. A comparison of the systemic toxicity of lidocaine versus its quaternary derivative QX-314 in mice. Can J Anaesth. 2011;58:443-450.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Kamil Budzeń, Paweł Wesołowski, Sebastian Bąk, Tomasz Stachura, Przemysław Żelazny
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 486
Number of citations: 0
