Intravenous Lidocaine for Acute Pain: A Single-Institution Retrospective Study

Area of Science:

• Anesthesiology and Pain Management
• Pharmacology
• Surgical Outcomes

Background:

• Intravenous lidocaine is utilized perioperatively for opioid-sparing analgesia.
• It possesses anti-inflammatory and anti-hyperalgesic properties.

Purpose of the Study:

• To review the utilization, efficacy, and safety of intravenous lidocaine.
• To identify specific surgical and patient populations benefiting from its use within an Acute Pain Service (APS).

Main Methods:

• Retrospective analysis of 394 patients receiving intravenous lidocaine infusions (Feb 2013-Dec 2017).
• Data included demographics, surgery type, infusion duration, pain scores (rest/active), analgesic consumption, and adverse events.
• Clinically Important Differences (CIDs) defined as ≥2 point or ≥30% reduction in pain scores.

Main Results:

• 56.1% of patients achieved a CID in pain scores.
• Benefits observed in chronic pain patients (53.5%) and as rescue therapy (69.6%).
• Rescue cohort showed significant opioid consumption reduction (23.0% opioid-dependent, 45.6% opioid-naïve). Mild toxicity in 37 patients, one serious adverse event.

Conclusions:

• Intravenous lidocaine demonstrates benefits in specific postoperative surgical and patient populations.
• Findings support its use within an APS protocol.
• Further research is recommended for confirmation.