PMID- 34265786
OWN - NLM
STAT- MEDLINE
DCOM- 20210831
LR  - 20230827
IS  - 1536-5409 (Electronic)
IS  - 0749-8047 (Linking)
VI  - 37
IP  - 9
DP  - 2021 Sep 1
TI  - Evaluating the Safety of Continuous Infusion Lidocaine for Postoperative Pain.
PG  - 657-663
LID - 10.1097/AJP.0000000000000960 [doi]
AB  - OBJECTIVES: The aim was to evaluate the safety of intravenous lidocaine for 
      postoperative pain and the impact on opioid requirements and pain scores. 
      MATERIALS AND METHODS: This was a single-center, retrospective, single-arm 
      analysis of adult patients who received intravenous lidocaine for postoperative 
      pain from January 2016 to December 2019. Patients were excluded if they received 
      lidocaine for any indication other than pain or if lidocaine was only given 
      intraoperatively. The primary outcome of this analysis was to determine the 
      incidence of adverse effects (AEs) and the reason for discontinuation of 
      lidocaine. Secondary outcomes included median daily pain scores (visual analog 
      scale and Critical-Care Pain Observation Tool) and opioid consumption (daily 
      morphine milligram equivalents) 24 hours before infusion and during day 1. 
      RESULTS: A total of 452 patients were evaluated of which 298 (65.9%) patients met 
      inclusion criteria. Of the 154 patients excluded, 153 did not receive lidocaine 
      postoperatively. The median duration of infusion was 34 [20:48] hours with a 
      median initial and maintenance rate of 1 mg/kg/h dosed on ideal body weight. In 
      our analysis, 174 (58.4%) patients had a documented AE during infusion and 38 
      (12.8%) had lidocaine discontinued because of an AE. The most common AE was 
      nausea in 62 (20.8%) patients and the most common reason for discontinuation was 
      confusion in 8 (2.7%) patients. Daily morphine milligram equivalents (P<0.001) 
      and visual analog scale (P<0.001) significantly decreased when comparing 24 hours 
      before infusion and day 1. CONCLUSION: Although a majority of patients receiving 
      lidocaine for postoperative pain experienced an AE, this did not result in 
      discontinuation in most patients.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Schuler, Brian R
AU  - Schuler BR
AD  - Department of Pharmacy, Brigham and Women's Hospital, Boston, MA.
FAU - Lupi, Kenneth E
AU  - Lupi KE
FAU - Szumita, Paul M
AU  - Szumita PM
FAU - Kovacevic, Mary P
AU  - Kovacevic MP
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin J Pain
JT  - The Clinical journal of pain
JID - 8507389
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Anesthetics, Local)
RN  - 98PI200987 (Lidocaine)
SB  - IM
MH  - Adult
MH  - Analgesics, Opioid/adverse effects
MH  - Anesthetics, Local/therapeutic use
MH  - Double-Blind Method
MH  - Humans
MH  - Infusions, Intravenous
MH  - *Lidocaine/adverse effects
MH  - Pain Measurement
MH  - *Pain, Postoperative/drug therapy
MH  - Retrospective Studies
COIS- The authors declare no conflict of interest.
EDAT- 2021/07/16 06:00
MHDA- 2021/09/01 06:00
CRDT- 2021/07/15 20:34
PHST- 2020/09/01 00:00 [received]
PHST- 2021/06/17 00:00 [accepted]
PHST- 2021/07/16 06:00 [pubmed]
PHST- 2021/09/01 06:00 [medline]
PHST- 2021/07/15 20:34 [entrez]
AID - 00002508-202109000-00003 [pii]
AID - 10.1097/AJP.0000000000000960 [doi]
PST - ppublish
SO  - Clin J Pain. 2021 Sep 1;37(9):657-663. doi: 10.1097/AJP.0000000000000960.