Effect Of Intravenous Lidocaine Infusion Research Articles

The impact of intraoperative intravenous lidocaine infusion on early postoperative pain after complex spine surgeries

BackgroundThis study aimed to assess the effect of intravenous lidocaine infusion affected on early postoperative pain control after complex spin surgeries.Ninety patients who were scheduled for complex spine surgery were included in this prospective double-blinded controlled trial. They were randomly assigned to one of two groups: L and P. Patients in group L received a loading dose of lidocaine 1 mg/kg then followed by 1.5 mg/kg/h infusion till the end of the surgery, while in group P, lidocaine was replaced with normal saline.ResultsThe pain score assessed by VAS at rest showed statistically significant lower values in group L at 30 min, 8, 12, and 24 h postoperatively. VAS during movement was significantly higher in group P only after 24 h postoperatively. The entire dose of intraoperative fentanyl consumed was significantly lower in group L. The time elapsed to ask for the first dose of rescue analgesia was significantly longer in group L. The first rescue dose of nalbuphine was significantly lower in group L. In group P, the overall dose of narcotics consumed in the first postsurgical day was significantly higher.ConclusionsWhen compared to placebo, lidocaine infusion significantly reduced the postoperative pain scores, as well as the entire dose of intraoperative and postoperative narcotics used.

Systemic Anti-Inflammatory Effects of Intravenous Lidocaine in Surgical Patients: A Systematic Review and Meta-Analysis.

There has recently been increasing evidence that the use of perioperative intravenous lidocaine infusion possesses analgesic, opioid-sparing and anti-inflammatory effects in surgical patients. Although opioid-sparing and analgesic properties have been strongly supported, the anti-inflammatory features are not well established in elective surgery. Therefore, the aim of this systematic review is to examine the effect of perioperative intravenous lidocaine infusion on postoperative anti-inflammatory status in patients undergoing elective surgery. A search strategy was created to identify suitable randomised clinical trials (RCTs) in PubMed, Scopus, Web of Science and Clinicaltrials.gov databases until January 2023. RCTs that evaluated the effect of intravenous lidocaine infusion, compared with placebo, on adult patients who underwent elective surgery, in inflammatory markers response were included. Exclusion criteria consisted of paediatric patients, animal studies, non-RCT methodology, intervention without intravenous lidocaine, inadequate control group, duplicated samples, ongoing studies and lack of any relevant clinical outcome measures. The following inflammatory markers-interleukin (IL)-6, tumour necrosis factor (TNF)-α, IL-1RA, IL-8, IL-10, C-reactive protein (CRP), IL-1, IL-1β, interferon (IFN)-γ, cortisol, IL-4, IL-17, high-mobility group protein B1 (HMGB1) and transforming growth factor (TGF)-β-were evaluated as outcomes in this review. A total of 21 studies, including 1254 patients, were identified. Intravenous lidocaine infusion significantly reduced the change from IL-6 baseline levels at the end of surgery compared to a placebo (standardised mean difference [SMD]: -0.647, 95% confidence interval [CI]: -1.034 to -0.260). Usage of lidocaine was associated with a significant reduction in other postoperative pro-inflammatory markers, such as TNF-α, IL-1RA, IL-8, IL-17, HMGB-1 and CRP. There was no significant difference in other markers, such as IL-10, IL-1β, IL-1, IFN-γ, IL-4, TGF-β and cortisol. This systematic review and meta-analysis provide support for the administration of perioperative intravenous lidocaine infusion as an anti-inflammatory strategy in elective surgery.

Sedation for Endoscopic Retrograde Cholangiopancreatography in Elderly Patients – the Effect of Intravenous Lidocaine Infusion. A Randomised, Double-Blind, Placebo Controlled Trial

Sedation of elderly patients with associated comorbidities, subjected to ERCP procedure, can produce serious complications including respiratory instability and hemodynamics caused by the administration of anesthetic substances. In this study we aimed to evaluate whether the administration of lidocaine in continuous infusion during ERCP procedure reduces the consumption of propofol and the rate of complications in these patients. 83 patients over 65-year old, ASA II-IV score, undergoing an ERCP procedure were randomized in two groups: lidocaine group (group L) who received 1.5 mg/kg lidocaine 1% and propofol 1mg/kg at induction and then 2 mg/kg lidocaine 1% in continuous infusion during the procedure and control group (group C) who received saline in the same amount as group L and propofol 1mg/kg. The consumption of propofol, intraprocedural complications, the time of awakening and recovery, the quality of postprocedural analgesia, the satisfaction of the endoscopist were registered. Propofol consumption was statistically significantly lower in group L compared to group C [135.37 (±43.23) vs. 214.88 (±51.83), p=0.001]. The same result was obtained related to the awakening time [2.85 (±1.50) vs. 5.38 (±1.36), p=0.001] and recovery time [23.90 (±12.66) vs. 26.17 (±12.41), p<0.001], the episodes of intraprocedural desaturation (p=0.001), the involuntary intraprocedural movements (p=0.001), the endoscopist's satisfaction (p=0.006). No differences were found in terms of post-procedure pain scores (p=0.54). Lidocaine can be administered to reduce the need for propofol, faster awakening and lower intraprocedural complications in elderly patients undergoing the ERCP procedure.

Effect of intravenous lidocaine infusion on perioperative cellular immunity and the quality of postoperative recovery in breast cancer patients: a randomized controlled trial.

Breast cancer has become the most common malignancy worldwide. Experimental and, retrospective, clinical data indicate that anaesthetic technique might influence the risk of metastasis after cancer surgery by modulating the immune system. The purpose of this study is to investigate the effect of perioperative lidocaine injection on immune cells such as T lymphocytes and natural killer cells (NK cells) and the quality of postoperative recovery in breast cancer patients and to propose new ideas and relevant theoretical evidence for the selection of anesthetic protocols for perioperative tumor patients. Women (n=68) undergoing primary breast tumour resection were randomly assigned to received 2% lidocaine (n=34; group L) or placebo (normal saline; n=34; group S). Venous blood was collected thirty minutes before surgery (T0), after tumor removal (T1), immediately after surgery (T2), 24 h after surgery (T3), and 48 h after surgery (T4). The percentages of NK cells and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) in peripheral blood were detected by flow cytometry. Patients' quality of recovery-15 (QoR-15) scores were recorded by questionnaire before and 24 h after the operation, as well as intraoperative propofol and remifentanil dosages, the frequency of 24 h postoperative remedial analgesia, and the incidence of nausea and vomiting, dizziness, and chest tightness. There were 62 patients included in the study, and 60 patients were finally analyzed. The difference in the changing trend of NK cell levels in the 2 groups over time was statistically significant (F=7.675, P=0.008). The intraoperative changing trends of CD3+ T cells, CD4+ T cells, and the CD4+/CD8+ ratio over time differed significantly between the 2 groups of patients (P<0.05), whereas the trends of CD8+ T cells did not differ significantly (P>0.05). The QoR-15 score at 24 h after surgery was higher in Group L (128.50±20.25) than in Group S (117.50±19.50), and the difference was statistically significant (P=0.005). No adverse events such as cardiac arrhythmia and lidocaine toxicity occurred in both groups during the perioperative period. Continuous intravenous pumping of lidocaine during the perioperative period has little effect on immune function in breast cancer patients and promotes postoperative recovery. Chinese Clinical Trial Registry ChiCTR2100050445.

Intravenous lidocaine vs. NSAIDs for migraine attack in the ED: a prospective, randomized, double-blind study.

Although different forms of lidocaine are used for migraine attack headaches, the effect of intravenous lidocaine is still limited. This study aimed to investigate the effects of intravenous lidocaine infusion for the treatment of migraine attack headaches. A hundred patients with migraine attacks, aged between 18 and 65, were randomly divided into two groups. The lidocaine group (n = 50) received a 1.5mg/kg lidocaine bolus and a 1mg/kg infusion (first 30min), followed by a 0.5mg/kg infusion for a further 30min intravenously. The non-steroidal anti-inflammatory drug (NSAID) group (n = 50) received 50mg dexketoprofen trometamol and saline at the same volume as the lidocaine at the same time intervals intravenously. The Visual Analog Scale (VAS) pain scores, additional analgesia requirement, side effects, and revisits to the emergency department were recorded. The VAS score was significantly lower in the lidocaine group than in the NSAID group for the first 20th and 30th minutes (p = 0.014 and p = 0.024, respectively). There was no difference between the VAS scores for the remaining evaluation times (p > 0.05). In terms of secondary outcomes, rescue medication requirement was not different between the two groups at both the 60th and 90th minutes (p > 0.05). However, the number of patients revisiting ED within 48-72h was statistically less in the lidocaine group than in the NSAID group (1/50 vs. 8/50; p = 0.031). Intravenous lidocaine may be an alternative treatment method for patients with migraine attack headaches in the emergency department.

Effect of Intravenous Lidocaine Infusion on Postoperative Early Recovery Quality in Upper Airway Surgery

Systemic infusions of lidocaine have been widely used as perioperative analgesic adjuvants. The aim of this randomized, double-blinded, controlled trial was to investigate the effect of perioperative lidocaine infusion on postoperative early recovery quality in upper airway surgery. Prospective, randomized, double-blinded, placebo-controlled trial. A total of 99 patients were randomly assigned to the lidocaine group (group L) or the control group (group C). The patients received 2 mg/kg lidocaine completed within 10 minutes before the induction of anesthesia followed by continuous infusions of 2 mg/kg/hr lidocaine (group L) or the same volume of 0.9% normal saline (group C) intravenously during anesthesia. The Quality of Recovery-40 (QoR-40) survey was administered on the preoperative day (Pre) and postoperative days 1 (POD1) and 2 (POD2). The primary endpoint was QoR-40 score on POD1 and POD2. Compared with Pre, global QoR-40 scores on POD1 and POD2 were significantly lower (P < .05). Compared with group C, global QoR-40 scores were significantly higher in group L on POD1 and POD2 (P < .05). Among the five dimensions of QoR-40, the scores for physical comfort, emotional state, and pain were superior in group L compared to group C (P < .05). Compared with group C, the consumption of remifentanil and diclofenac as well as the incidence of postoperative nausea and vomiting (PONV) and postoperative 48-hour numeric rating scale (NRS) scores in group L were significantly lower (P < .05). Systemic lidocaine infusion can improve QoR-40 scores in patients with upper airway surgery, reduce the dosage of intraoperative opioids, decrease the incidence of PONV and NRS scores 2 days after surgery, thus improving postoperative early recovery quality. 1b Laryngoscope, 131:E63-E69, 2021.

Intraoperative Intravenous Lidocaine Prevention of Vomiting in Adnexial Mass Operations

Objective: Postoperative Vomiting (POV) is a common complication in intraabdominal operations. The use of intravenous lidocaine infusion in adult patients who underwent abdominal surgery may prevent POV. We aimed to evaluate the anti-emetic effect of intravenous lidocaine infusion used as an adjuvant to general anesthesia in intra-abdominal operations. Patients: ASA I-III adult women aged 30 to 70 years scheduled for elective adnexal mass operations were selected. Intervention: We have standardized the induction and maintenance of anesthesia in our oncological surgery rooms. Patients were randomly administered lidocaine (1.5 mg.kg-1 intravenous (i.v) lidocaine followed by 2 mg.kg-1.h) or only 0.9% saline (same proportion and volume) for 5 minutes. Infusions were continued until the end of the surgery. Results: 200 women with adnexal mass were operated. In the lidocaine group, 60 (60%) of the 100 patients had POV and 80 (80%) of the 100 patients had POV in the Saline group. The probability of having POV was 20% less than patients receiving lidocaine in the Saline group. The mean lidocaine plasma concentration was 4.1 µg.ml-1 (range: 0.87 to 4.88). Conclusion: The use of intravenous lidocaine infusion as an adjunct to general anesthesia reduced POVN in oncology patients.

Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

Background: Post-operative outcomes of a major abdominal surgery depend on careful &amp; effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity &amp; enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings &amp; specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value &lt;0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p&lt;0.001)&amp; during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P&lt;0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% &amp; p was &lt;0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children &amp; it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

Effect of intravenous lidocaine infusion on long-term postoperative pain after spinal fusion surgery.

Background:Intravenous lidocaine infusion is known to reduce postoperative pain for days or weeks beyond the infusion time, and plasma half-life in several types of surgical procedures.Objectives:To evaluate the effect of intravenous (IV) lidocaine infusion on long term postoperative pain intensity for 3 months in patients undergoing spinal fusion surgery.Study Design:Prospective randomized, double-blinded study.Setting:Assiut University Hospital, Assiut, Egypt.Methods:Forty patients undergoing spinal fusion surgery were randomized into 2 equal groups (n = 20 in each). Patients in the lidocaine group received IV lidocaine at a dosage of 2.0 mg/kg slowly before induction of anesthesia, followed by lidocaine IV infusion at a rate of 3.0 mg/kg/h until the end of surgery. Patients in the control group received an equal volume of normal saline. The following data were assessed: pain by Visual Analog Score (VAS) at 1 hour, 6 hours, 12 hours, 24 hours, 48 hours, at discharge time, and at 1 month, 2 months, and 3 months post-operation, time to first request for additional analgesia, and total morphine consumption in 24 hours.Results:Lidocaine significantly reduced the postoperative pain score (VAS) for up to 3 months (P < .05), and significantly reduced morphine consumption (4.5 mg vs. 19.85 mg) in the 1st 24 hours postoperative. Lidocaine also significantly, prolonged (P < .05) the time to first request for additional analgesia (9.56 ± 2.06 hours vs 1.82 ± 0.91 hours).Conclusion:Intra-operative lidocaine, when given intravenously as a bolus followed by an infusion, significantly decreased long term postoperative back pain intensity in patients undergoing spinal fusion surgery.

The effect of intravenous lidocaine infusion on bispectral index during major abdominal surgery.

Intraoperative lidocaine infusion has become widely accepted as an adjunct to general anesthesia where its use has been associated with opioid-sparing and enhanced recovery. The aims of this study were to determine whether or not intravenous (IV) lidocaine infusion (a) has an anesthetic sparing effect during major colorectal procedures and (b) if it also affects level of hypnosis as measured by bispectral index (BIS). Twenty-five patients undergoing laparotomy for resection of colorectal tumours were randomized to receive either IV lidocaine (1.5mg kg-1 bolus then 1mg kg-1 per hour) or an equivalent volume of normal saline commenced after intravenous induction of general anesthesia. Anesthesia was maintained with volatile anesthetic agent combined with intermittent IV fentanyl titrated to hemodynamic stability. Minimum alveolar concentration (MAC) of volatile was calculated using an age-adjusted algorithm (corrected MAC). BIS values were recorded throughout; however, treating anesthesiologists were blinded to BIS values and hence they were not used to guide depth of anesthesia. No other regional anesthesia techniques were used. During the maintenance phase of anesthesia, corrected MAC of volatile agent was lower (1.0 versus 1.1, p = 0.003); whereas BIS values were higher (45 versus 39, p < 0.001) in patients who received lidocaine versus placebo. No differences in mean arterial pressure (80 versus 80mmHg, p = 0.796) or total fentanyl dose (538 versus 444 mcg, p = 0.24) were observed between the two groups. Heart rate was slightly higher in patients who received lidocaine versus placebo (67 versus 64bpm, p = 0.001). Lidocaine infusion resulted in mean plasma levels of 1.7 mcg ml-1 (1.3-2.0 mcg ml-1, 95% CI). Our results support an anesthetic sparing effect of lidocaine infusion indicated by lower MAC requirements. Higher BIS values in the lidocaine versus placebo group may indicate that levels of hypnosis were not equivalent. Alternatively, BIS may not be a sensitive indicator of synergistic interactions between local anesthetic and volatile agent. Our results advocate a cautious approach to titration of general anesthesia when combined with lidocaine infusion.

A Comparative Study of Effect of Intravenous Lidocaine Infusion, Gabapentin and Their Combination on Postoperative Analgesia after Thyroid Surgery

Objective: This prospective randomized study aimed to evaluate the effect of IV lidocaine infusion or gabapentin and their combination in providing efficient analgesia after thyroid surgery. Methods: Eighty-eight patients scheduled for thyroidectomy were randomized into four equal groups (n = 22). Group P (placebo) patients received placebo capsules 1 h preoperatively and intravenous (IV) saline infusion. Group L (Lidocaine): patients received placebo capsules 1 h preoperatively and IV bolus lidocaine 1.0 mg/kg followed by infusion 2 mg/kg/h. Group G (Gabapentin) patients received 600 mg gabapentin capsules 1 h preoperatively and IV saline infusion. Group LG (Lidocaine-Gabapentin) patients received 600 mg gabapentin capsules 1 h preoperatively and IV bolus of 1.0 mg/kg lidocaine followed by infusion 2 mg/kg/h. (lidocaine or saline infusion started before induction of anesthesia and continued until the end of surgery). Intraoperative fentanyl consumption and hemodynamic changes were recorded. Postoperative total tramadol consumption, time to first analgesic request, visual analog scale (VAS) of pain, sedation level, and side effects were assessed for 24 hours. Results: (LG) group had significant lower intraoperative fentanyl and lower postoperative tramadol consumption (p < 0.001) compared to (P), (L) and (G) groups, with prolonged time of first analgesic request (p < 0.001) compared to (P) and (L) groups, and lower VAS compared to other groups (p < 0.001 or p < 0.01). There was significantly lower postoperative nausea and vomiting (PONV) in G & LG groups compared to (P) group (p < 0.01). Conclusion: The combination of preoperative gabapentin and intraoperative lidocaine infusion provided more analgesic effect than either drug alone with lower and more delayed postoperative analgesic requirements and lower VAS. (PONV) was lower in groups received gabapentin.

Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal gastrectomy: a prospective, randomized, double-blind, placebo-controlled study.

Pre-emptive intravenous lidocaine infusion is known to improve postoperative pain in abdominal surgery. We assessed the effect of intravenous lidocaine infusion in patients who underwent subtotal gastrectomy. We conducted a double-blind, placebo-controlled study with patients undergoing subtotal gastrectomy for early gastric cancer divided into 2 groups: 1 group received intravenous lidocaine infusion preoperatively and throughout surgery, and the other received normal saline infusion (placebo). We assessed postoperative outcomes, including pain scores on a visual analogue scale (VAS), administration frequency of patient-controlled analgesia (PCA) and the amount of consumed fentanyl. Postoperative nausea and vomiting, length of hospital stay (LOS), time to return to regular diet and patient satisfaction at discharge were evaluated. There were 36 patients in our study. Demographic characteristics were similar between the groups. The VAS pain scores and administration frequency of PCA were significantly lower in the lidocaine group until 24 hours after surgery, and fentanyl consumption was significantly lower in this group until 12 hours postoperatively compared with the placebo group. The total amount of consumed fentanyl and the total administration frequency of PCA were significantly lower in the lidocaine than the control group. No significant differences were detected in terms of nausea and vomiting, return to regular diet, LOS and patient satisfaction, and there were no reported side-effects of lidocaine. Intravenous lidocaine infusion reduces pain during the postoperative period after subtotal gastrectomy.

The effects of intravenous lidocaine infusion on hospital stay after major abdominal pediatric surgery. A randomized double-blinded study

BackgroundLidocaine attenuates the stress response to surgery when given intravenously. This study investigated the effect of perioperative lidocaine infusion on hormonal responses, bowel function and hospital stay after major abdominal surgeries in pediatrics.MethodsAfter obtaining the Research Ethics Board (REB) approval and written informed parental consent, 80 pediatric patients aged 1–6 years, ASA II, III scheduled for abdominal major surgery were randomly allocated into two groups, each of forty children. Twenty minutes before induction, children in placebo group received saline in a rate of 1.5 ml/kg/h and those in lidocaine group received lidocaine 1.5 mg/kg intravenously then infusion of 1.5 mg/kg/h up to 6 h postoperatively. Length of hospital stay and return of bowel function were reported. Plasma cortisol was recorded at baseline, 10 min after continuous infusion, 5 min after intubation and 10 min after extubation. Serum lidocaine concentrations were recorded 10 min after start of infusion, 10 min and 4 h after extubation.ResultsPatients in placebo group showed significant higher plasma cortisol concentrations (P = 0.001) in response to induction of anesthesia and extended postoperatively when compared to lidocaine group.Hospital stay was significantly less in lidocaine group (5 ± 2 days) compared to placebo group (7 ± 2 days; P = 0.03). Also, fentanyl (μg/kg/d) requirement was significantly less in lidocaine group (5.4 ± 2.9 on 1st postoperative day and 4.1 ± 2.6 on 2nd postoperative day) compared to placebo group (14.4 ± 2.5 on 1st postoperative day and 12.6 ± 3.3 on 2nd postoperative day). Moreover, return of bowel function was earlier in lidocaine group compared to placebo group (19 ± 6.2 h vs. 23 ± 3.65 h respectively).ConclusionIntravenous lidocaine infusion, started preoperatively and continued for 6 h postoperatively, attenuated stress response to major abdominal pediatric surgery. It also decreased hospital stay, opioid requirement and hastened return of bowel function.

Effect of intravenous lidocaine infusion on sevoflurane requirements as monitored by bispectral index: A randomized double-blinded controlled study

IntroductionSystemic administration of lidocaine significantly decreased propofol requirements when compared to patients receiving placebo. Several studies conducted on animals have proved that systemic local anesthetics reduced minimum alveolar concentration (MAC) of inhalational anesthetics. The aim of this investigation is to study the effect of intravenous administration of lidocaine on the minimum alveolar concentration of sevoflurane required to keep BIS between 40 and 60 during maintenance of anesthesia in humans.MethodsTwenty-eight ASA I–II adults planned to undergo laparoscopic procedures expected to last <2 h under general anesthesia were randomly assigned to 2 groups. After standardized induction of general anesthesia, patients were given IV lidocaine bolus (1.5 mg kg−1) followed by 2 mg kg−1 h−1 infusion (group L, n = 14) or equal volumes of saline (group C, n = 14). Primary outcome of the study was end-tidal sevoflurane at bispectral index (BIS) values of 40–60. Secondary outcomes included doses of opioids, BIS values, and extubation time.ResultsThe median doses of intraoperative fentanyl (range) in group C were similar to group L (P = 0.08). There were no significant differences between the 2 groups regarding BIS at any time point. End-tidal sevoflurane concentrations were significantly higher in group C than in group L at all intraoperative time points (P < 0.05). Extubation time was longer in group L than in group C (P = 0.04).ConclusionIn conclusion, intravenous lidocaine administration, during maintenance of general anesthesia, can decrease BIS-guided sevoflurane requirements.

Intravenous lidocaine infusion in the treatment of experimental human skin burns — digital colour image analysis of erythema development

Previous studies have shown that local anaesthetics possess a wide range of effects on the pathophysiology of burns, including inhibition of burn oedema and inhibition of progressive burn ischemia. The present randomised double-blind cross-over study in six volunteers investigated the effects of intravenous lidocaine infusion on partial thickness skin burns. A thermoprobe was used to induce a standardised thermal injury (1 cm 2) on the flexor side of one forearm and was repeated on the opposite side 1 week later. Subjects received either an intravenous bolus dose of lidocaine (1 mg kg −1) immediately after the thermal trauma followed by continuous intravenous infusion of lidocaine (40 μg kg −1 min −1) during 4 h or equal volumes of isotonic saline. Macrophotographs of the experimental skin area were taken preburn and 1, 2, 3, 4, and 12 h postburn and evaluated by computerised image colour analysis using normalised rgb ( n-rgb) and Hue–Saturation–Intensity (HSI) colour systems as a quantitative measure of pathophysiological events. Maximum erythema occurred 2–3 h postburn. Differences between lidocaine- and placebo-treated burns were not significant during the first 4 h postburn. At 12 h postburn, the lidocaine-treated burn demonstrated a significantly faster restitution of residual erythema compared to control sites. The present study shows that intravenous lidocaine significantly inhibits the long-term inflammation-induced tissue responses to thermal trauma.

The Effect of Intravenous Lidocaine Infusion on Succinylcholine - or Vecuronium - induced Neuromuscular Block in the Cat

The Effect of Intravenous Lidocaine Infusion on Succinylcholine - or Vecuronium - induced Neuromuscular Block in the Cat