Terkawi, A.S., Durieux, M.E., Gottschalk, A., Brenin, D., & Tiouririne, M. (2014). Effect of intravenous lidocaine on postoperative recovery of patients undergoing mastectomy: A double-blind, placebo-controlled randomized trial. Regional Anesthesia and Pain Medicine, 39, 472–477. 

DOI Link

Study Purpose

To test the effects of intraoperative IV lidocaine on postoperative recovery

Intervention Characteristics/Basic Study Process

Prior to surgery, patients were randomized to receive lidocaine infusion or placebo of normal saline. This was given as a bolus prior to anesthetic induction in a dose up to 1.5 mg/kg. Two hours after arrival to the post-anesthesia care unit (PACU), patients were given an infusion of lidocaine or placebo at 2 mg/kg per hour for up to two hours or discharge from the PACU. All patients had general anesthesia, but specific agents used and postoperative analgesia were not standardized. Pain was assessed at 2, 24, and 48 hours, and opioid consumption was documented.

Sample Characteristics

  • N = 71   
  • MEAN AGE = 53.5 years
  • FEMALES: 100%
  • CURRENT TREATMENT: Other
  • KEY DISEASE CHARACTERISTICS: All were undergoing mastectomy for breast cancer, and 64% had simple mastectomy.
  • OTHER KEY SAMPLE CHARACTERISTICS: No differences existed between groups in duration of surgery.
 

 

Setting

  • SITE: Single site   
  • SETTING TYPE: Inpatient    
  • LOCATION: Virginia

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

  • Double-blind, placebo-controlled, randomized controlled trial

Measurement Instruments/Methods

  • Numeric Pain Rating Scale (NPRS)

Results

There were no significant differences between groups in pain scores or overall opioid consumption.

Conclusions

Perioperative IV lidocaine was not shown to reduce postoperative pain or opioid consumption.

Limitations

  • Small sample (< 100)
  • Findings not generalizable
  • Efficacy may depend upon the extent of surgery and associated levels of pain.

Nursing Implications

Use of perioperative IV lidocaine did not have an effect on postoperative pain or need for analgesics in this study. Study investigators pointed out that there are some mixed findings in this area, and that efficacy of perioperative infusion of anesthetics may differ according to the extent and type of surgery.