The Role of Intravenous Lidocaine in Preventing Chronic Post-Operative Pain

Authors

  • Luís M. F. Ramos Department of Anesthesiology, Centro Hospitalar Universitário Lisboa Central, Rua António Serrano, Lisbon 1150199, Portugal

DOI:

https://doi.org/10.17140/RPAOJ-5-127

Keywords:

Chronic pain, Chronic post-operative pain, Chronic post-surgical pain, Intravenous lidocaine

Abstract

Background and Goal of Study
Chronic post-operative pain (CPOP) is an increasing public health issue considering its impact on the patients quality of life and and the associated costs for the healthcare system. The incidence of CPOP can be as high as 75%, depending on the surgical procedure and other factors. Lidocaine is a local anesthetic with anti-inflammatory, analgesic and antihyperalgesic properties. Several studies have shown its use in controlling acute post-operative pain when used intravenously. The goal of this study was to define the role of intravenous lidocaine in preventing CPOP.
Materials and Methods
The PubMed database was searched from 2006 and 2019 with the keywords: “Chronic post-operative pain” or “Chronic post-surgical pain” or “Chronic pain” and “Intravenous lidocaine”. Adequate papers for the purpose of this study were selected.
Results and Discussion
Three randomized controlled trials that met criteria were obtained: two on breast surgery and the other on open nephrectomy. All trials used intravenous lidocaine during surgery, suspending the infusion up to the first 24-hours of the post-operative period. All three of them showed a significant decrease on the incidence of CPOP. There was a 20-fold decrease six months after breast surgery.

Conclusion
Intravenous lidocaine seems to decrease the incidence of CPOP however, there is limited evidence. More trials are necessary to define the efficacy and safety of intravenous lidocaine. A generally accepted definition of CPOP is needed.

References

Macrae WA. Chronic postsurgical pain: 10 years on. Bu J Anaesth. 2006; 101: 77-86. doi: 10.1093/bja/aen099

Pozek JP, Beausang D, Baratta JL, Viscusi ER. The acute to chronic pain transition: Can chronic pain be prevented? Med Clin North Am. 2016; 100(1): 17-30. doi: 10.1016/j.mcna.2015.08.005

Kurmann A, Fischer H, Dell-Kuster S, Rosenthal R, Audige L, Schupfer G, et al. Effect of intraoperative infiltration with local anesthesia on the development of chronic pain after inguinal her-nia repair: A randomized, triple-blinded, placebo-controlled trial. Surgery. 2015; 157(1): 144-154. doi: 10.1016/j.surg.2014.07.008

Remérand F, Godfroid HB, Brilhault J, Vourc´h R, Druon J, Laf-fon M, et al. Chronic pain 1 year after foot surgery: Epidemiology and associated factors. Orthop Traumatol Surg Res. 2014; 100: 767- 773. doi: 10.1016/j.otsr.2014.07.012

Brandsborg B. Pain following hysterectomy: Epidemiological and clinical aspects. Dan Med J. 2012; 59: B4374.

Voscopoulos C, Lema M. When does acute pain become chron-ic? Brit J Anaesth. 2010; 105(suppl 1): i69–i85. doi: 10.1093/bja/ aeq323

Ruscheweyh R, Wilder-Smith O, Drdla R, Liu XG, Sandkühler J. Long-term potentiation in spinal nociceptive pathways as a novel target for pain therapy. Mol Pain. 2011; 7: 20. doi: 10.1186/1744- 8069-7-20

Souza MF, Kraychete DC. A ação analgésica da lidocaína intrave-nosa no tratamento da dor crônica: Uma revisão de literatura. Rev Bras Reumatol. 2014; 54(5): 386-392. doi: 10.1016/j.rbr.2014.01.010

Oliveira CM, Issy AM, Sakata RK. Intraoperative intravenous li-docaine. Rev Bras Anestesiol 2010; 60: 325-333. doi: 10.1016/S0034- 7094(10)70041-6

Van Der Wal SEI, Van Den Heuvel SAS, Radema SA, van Ber-kum BFM, Vaneker M, Steegers MAH, et al. The in vitro mecha-nisms and in vivo efficacy of intravenous lidocaine on the neuro-inflammatory response in acute and chronic pain. Eur J Pain. 2016; 20(5): 655-674. doi: 10.1002/ejp.794 Submit your article to this journal | https://openventio.org/submit-manuscript/ 4 Ramos LMF

Cheng GS, Ilfield BM. An evidence-based review of the effi-cacy of perioperative analgesic techniques for breast cancer-related surgery. Pain Med. 2016; 18(7): 1-22. doi: 10.1093/pm/pnw172

Grigoras A, Lee P, Sattar F, Shorten G. Perioperative intra-venous lidocaine decreases the incidence of persistent pain af-ter breast surgery. Clin J Pain. 2012; 28: 567-572. doi: 10.1097/ AJP.0b013e31823b9cc8

Terkawi AS, Sharma S, Durieux ME, Thammishetti S, Brenin D, Tiouririne M. Perioperative lidocaine infusion reduces the inci-dence of post-mastectomy chronic pain: A double-blind, placebo-controlled randomized trial. Pain Physician. 2015; 18: E139-E146.

Jendoubi A, Naceur IB, Bouzouita A, Trifa M, Ghedira S, Che-bil M et al. A comparison between intravenous lidocaine and ket-amine on acute chronic pain after open nephrectomy: a prospec-tive, double-blind, randomized, placebo-controlled study. Saudi J Anaesth. 2017; 11(2): 177-184. doi: 10.4103/1658-354X.203027 Systematic Review | Volume 5 | Number 1 |

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Published

2021-03-18

How to Cite

Luís M. F. Ramos. (2021). The Role of Intravenous Lidocaine in Preventing Chronic Post-Operative Pain. Research and Practice in Anesthesiology, 5(1), 1–4. https://doi.org/10.17140/RPAOJ-5-127

Issue

Vol. 5 No. 1 (2021): Volume 5 Issue 1 2021

Section

Articles

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