Evaluation of the efficacy and safety of intravenous lidocaine for the management of acute postoperative pain – current state of knowledge

Abstract: The management of acute post-operative pain is an integral part of surgical procedures. Untreated pain leads to many complications. In anesthetic procedures, multilevel formation and processing of a pain stimulus requires multidirectional treatment. This concept of proceedings is called multimodal analgesia. On the one hand, it enables the effective pain control and on the other hand, minimizes the number of complications resulting from side effects of the drugs used. The basic group of drugs applied to fight acute post-operative pain are opioids, which are according to the concept of multimodal treatment supplemented with non-opioid analgesics, regional anesthesia or a group of drugs called adjuvants. Adjuvants, or supportive medicines, are the basic substances given in other cases. This group includes intravenous (i.v.) lidocaine. The first report on an attempt to use i.v. lidocaine in the management of acute surgical pain comes from 1954. Some recommendations for the management of postoperative pain from 2014 contain i.v. lidocaine, which has been included as a drug from the group of adjuvants. Its optimal way of administration, however, is still an open question. Based on current scientific reports, it seems that the anesthetic procedure involving the supply of i.v. lidocaine as an adjuvant drug in the postoperative pain therapy is justified by clinical benefits in specific surgical procedures. It is limited, however, to the field of abdominal surgery. The literature review concluded this usage may be beneficial for a specific group of patients, but protocols vary.

Anna Starczewska, Lidia Lysenko

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