Education  |   April 2017
Perioperative Use of Intravenous Lidocaine
Author Notes
  • From the Departments of Anesthesiology (L.K.D., M.E.D.) and Neurosurgery (M.E.D.), University of Virginia, Charlottesville, Virginia.
  • This article has been selected for the Anesthesiology CME Program. Learning objectives and disclosure and ordering information can be found in the CME section at the front of this issue.
    This article has been selected for the Anesthesiology CME Program. Learning objectives and disclosure and ordering information can be found in the CME section at the front of this issue.×
  • This article is featured in “This Month in Anesthesiology,” page 1A.
    This article is featured in “This Month in Anesthesiology,” page 1A.×
  • Figure 1 was enhanced by Annemarie B. Johnson, C.M.I., Medical Illustrator, Vivo Visuals, Winston-Salem, North Carolina.
    Figure 1 was enhanced by Annemarie B. Johnson, C.M.I., Medical Illustrator, Vivo Visuals, Winston-Salem, North Carolina.×
  • Submitted for publication March 23, 2016. Accepted for publication December 28, 2016.
    Submitted for publication March 23, 2016. Accepted for publication December 28, 2016.×
  • Address correspondence to Dr. Dunn: Department of Anesthesiology, University of Virginia Health System, P. O. Box 800710, Charlottesville, Virginia 22908. lak3r@hscmail.mcc.virginia.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Education / Clinical Concepts and Commentary / Pain Medicine / Pharmacology
Education   |   April 2017
Perioperative Use of Intravenous Lidocaine
Anesthesiology 4 2017, Vol.126, 729-737. doi:10.1097/ALN.0000000000001527
Anesthesiology 4 2017, Vol.126, 729-737. doi:10.1097/ALN.0000000000001527
CONCERN about opioid risks in the postoperative period1  has spurred an increased interest in the use of nonopioid analgesic adjuncts. One drug of potential interest is IV lidocaine, which can be administered intra- and/or postoperatively in order to decrease postoperative pain and improve other outcomes. A number of studies and meta-analyses of these studies have been published and show that perioperative lidocaine infusion is indeed effective but that evidence supporting its use varies by surgical procedure. This makes it difficult for anesthesiologists to decide when use of the compound would be clinically indicated.
This article will address this issue. First, a brief overview will be provided of the mechanisms that could explain a prolonged postoperative benefit of perioperative lidocaine infusion. Although these mechanisms are poorly understood, it is important for the clinician to understand how such effects conceivably could happen. The clinical literature on perioperative IV lidocaine will then be reviewed, providing evidence for when this approach may and may not be clinically useful.
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