Intravenous Lignocaine as an Analgesic Adjunct in Adolescent Idiopathic Scoliosis Surgery

Summary

This is a single-center study comparing the effect of intravenous (IV) Lignocaine given throughout posterior spinal fusion surgery on the reduction of morphine usage during postoperative period in adolescent idiopathic scoliosis (AIS) patients.

Timeline

Start

2020-12-24

Primary completion

2022-03-31

Completion

2022-09-30

Publications

• Background Beilin B, Shavit Y, Trabekin E, Mordashev B, Mayburd E, Zeidel A, Bessler H. The effects of postoperative pain management on immune response to surgery. Anesth Analg. 2003 Sep;97(3):822-827. doi: 10.1213/01.ANE.0000078586.82810.3B.
• Background Groudine SB, Fisher HA, Kaufman RP Jr, Patel MK, Wilkins LJ, Mehta SA, Lumb PD. Intravenous lidocaine speeds the return of bowel function, decreases postoperative pain, and shortens hospital stay in patients undergoing radical retropubic prostatectomy. Anesth Analg. 1998 Feb;86(2):235-9. doi: 10.1097/00000539-199802000-00003.
• Background Kaba A, Laurent SR, Detroz BJ, Sessler DI, Durieux ME, Lamy ML, Joris JL. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. Anesthesiology. 2007 Jan;106(1):11-8; discussion 5-6. doi: 10.1097/00000542-200701000-00007.
• Background Ben-Shlomo I, Tverskoy M, Fleyshman G, Cherniavsky G. Hypnotic effect of i.v. propofol is enhanced by i.m. administration of either lignocaine or bupivacaine. Br J Anaesth. 1997 Apr;78(4):375-7. doi: 10.1093/bja/78.4.375.
• Background Himes RS Jr, DiFazio CA, Burney RG. Effects of lidocaine on the anesthetic requirements for nitrous oxide and halothane. Anesthesiology. 1977 Nov;47(5):437-40. doi: 10.1097/00000542-197711000-00010.
• Background Rehberg B, Xiao YH, Duch DS. Central nervous system sodium channels are significantly suppressed at clinical concentrations of volatile anesthetics. Anesthesiology. 1996 May;84(5):1223-33; discussion 27A. doi: 10.1097/00000542-199605000-00025.
• Background Kim WY, Lee YS, Ok SJ, Chang MS, Kim JH, Park YC, Lim HJ. Lidocaine does not prevent bispectral index increases in response to endotracheal intubation. Anesth Analg. 2006 Jan;102(1):156-9. doi: 10.1213/01.ANE.0000184040.85956.98.
• Background Myles PS, Leslie K, McNeil J, Forbes A, Chan MT. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial. Lancet. 2004 May 29;363(9423):1757-63. doi: 10.1016/S0140-6736(04)16300-9.
• Background Pandit JJ, Andrade J, Bogod DG, Hitchman JM, Jonker WR, Lucas N, Mackay JH, Nimmo AF, O'Connor K, O'Sullivan EP, Paul RG, Palmer JH, Plaat F, Radcliffe JJ, Sury MR, Torevell HE, Wang M, Hainsworth J, Cook TM; Royal College of Anaesthetists; Association of Anaesthetists of Great Britain and Ireland. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors. Br J Anaesth. 2014 Oct;113(4):549-59. doi: 10.1093/bja/aeu313. Epub 2014 Sep 9.
• Background Hadley MN, Shank CD, Rozzelle CJ, Walters BC. Guidelines for the Use of Electrophysiological Monitoring for Surgery of the Human Spinal Column and Spinal Cord. Neurosurgery. 2017 Nov 1;81(5):713-732. doi: 10.1093/neuros/nyx466. No abstract available.
• Background Haghighi SS, Madsen R, Green KD, Oro JJ, Kracke GR. Suppression of motor evoked potentials by inhalation anesthetics. J Neurosurg Anesthesiol. 1990 Jun;2(2):73-8. doi: 10.1097/00008506-199006000-00003.
• Background Huotari AM, Koskinen M, Suominen K, Alahuhta S, Remes R, Hartikainen KM, Jantti V. Evoked EEG patterns during burst suppression with propofol. Br J Anaesth. 2004 Jan;92(1):18-24. doi: 10.1093/bja/aeh022.
• Background Oliveira CM, Sakata RK, Slullitel A, Salomao R, Lanchote VL, Issy AM. [Effect of intraoperative intravenous lidocaine on pain and plasma interleukin-6 in patients undergoing hysterectomy]. Rev Bras Anestesiol. 2015 Mar-Apr;65(2):92-8. doi: 10.1016/j.bjan.2013.07.017. Epub 2014 Nov 7. Portuguese.
• Background Kurabe M, Furue H, Kohno T. Intravenous administration of lidocaine directly acts on spinal dorsal horn and produces analgesic effect: An in vivo patch-clamp analysis. Sci Rep. 2016 May 18;6:26253. doi: 10.1038/srep26253.
• Background Kandil E, Melikman E, Adinoff B. Lidocaine Infusion: A Promising Therapeutic Approach for Chronic Pain. J Anesth Clin Res. 2017 Jan;8(1):697. doi: 10.4172/2155-6148.1000697. Epub 2017 Jan 11.
• Background Doig GS, Simpson F. Randomization and allocation concealment: a practical guide for researchers. J Crit Care. 2005 Jun;20(2):187-91; discussion 191-3. doi: 10.1016/j.jcrc.2005.04.005.
• Background Chan CYW, Kwan MK. Perioperative Outcome in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: A Prospective Study Comparing Single Versus Two Attending Surgeons Strategy. Spine (Phila Pa 1976). 2016 Jun;41(11):E694-E699. doi: 10.1097/BRS.0000000000001349.
• Background Kwan MK, Chan CY. Does a dual attending surgeon strategy confer additional benefit for posterior selective thoracic fusion in Lenke 1 and 2 adolescent idiopathic scoliosis (AIS)? A prospective propensity matching score analysis. Spine J. 2017 Feb;17(2):224-229. doi: 10.1016/j.spinee.2016.09.005. Epub 2016 Sep 5.
• Background Miyabe M, Kakiuchi Y, Kihara S, Takahashi S, Kohda Y, Sato S, Toyooka H. The plasma concentration of lidocaine's principal metabolite increases during continuous epidural anesthesia in infants and children. Anesth Analg. 1998 Nov;87(5):1056-7. doi: 10.1097/00000539-199811000-00016. No abstract available.
• Results Farag E, Ghobrial M, Sessler DI, Dalton JE, Liu J, Lee JH, Zaky S, Benzel E, Bingaman W, Kurz A. Effect of perioperative intravenous lidocaine administration on pain, opioid consumption, and quality of life after complex spine surgery. Anesthesiology. 2013 Oct;119(4):932-40. doi: 10.1097/ALN.0b013e318297d4a5.
• Results Grassi P, Bregant GM, Crisman M. Systemic intravenous lidocaine for perioperative pain management: a call for changing indications in the package sheet. Heart Lung Vessel. 2014;6(2):137-8. No abstract available.
• Results McCarthy GC, Megalla SA, Habib AS. Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. Drugs. 2010 Jun 18;70(9):1149-63. doi: 10.2165/10898560-000000000-00000.
• Results Koppert W, Weigand M, Neumann F, Sittl R, Schuettler J, Schmelz M, Hering W. Perioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery. Anesth Analg. 2004 Apr;98(4):1050-1055. doi: 10.1213/01.ANE.0000104582.71710.EE.
• Results Greenwood E, Nimmo S, Paterson H, Homer N, Foo I. Intravenous lidocaine infusion as a component of multimodal analgesia for colorectal surgery-measurement of plasma levels. Perioper Med (Lond). 2019 Feb 26;8:1. doi: 10.1186/s13741-019-0112-4. eCollection 2019.
• Results Both CP, Thomas J, Buhler PK, Schmitz A, Weiss M, Piegeler T. Factors associated with intravenous lidocaine in pediatric patients undergoing laparoscopic appendectomy - a retrospective, single-centre experience. BMC Anesthesiol. 2018 Jul 18;18(1):88. doi: 10.1186/s12871-018-0545-1.
• Results Choi SJ, Kim MH, Jeong HY, Lee JJ. Effect of intraoperative lidocaine on anesthetic consumption, and bowel function, pain intensity, analgesic consumption and hospital stay after breast surgery. Korean J Anesthesiol. 2012 May;62(5):429-34. doi: 10.4097/kjae.2012.62.5.429. Epub 2012 May 24.
• Results Bazin P, Padley J, Ho M, Stevens J, Ben-Menachem E. The effect of intravenous lidocaine infusion on bispectral index during major abdominal surgery. J Clin Monit Comput. 2018 Jun;32(3):533-539. doi: 10.1007/s10877-017-0035-x. Epub 2017 Jun 16.
• Results Altermatt FR, Bugedo DA, Delfino AE, Solari S, Guerra I, Munoz HR, Cortinez LI. Evaluation of the effect of intravenous lidocaine on propofol requirements during total intravenous anaesthesia as measured by bispectral index. Br J Anaesth. 2012 Jun;108(6):979-83. doi: 10.1093/bja/aes097. Epub 2012 Apr 6.
• Results Weber U, Krammel M, Linke S, Hamp T, Stimpfl T, Reiter B, Plochl W. Intravenous lidocaine increases the depth of anaesthesia of propofol for skin incision--a randomised controlled trial. Acta Anaesthesiol Scand. 2015 Mar;59(3):310-8. doi: 10.1111/aas.12462. Epub 2015 Jan 13.
• Results Cui W, Li Y, Li S, Wang R, Li J. Systemic administration of lidocaine reduces morphine requirements and postoperative pain of patients undergoing thoracic surgery after propofol-remifentanil-based anaesthesia. Eur J Anaesthesiol. 2010 Jan;27(1):41-6. doi: 10.1097/EJA.0b013e32832d5426.
• Results Hans GA, Lauwick SM, Kaba A, Bonhomme V, Struys MM, Hans PC, Lamy ML, Joris JL. Intravenous lidocaine infusion reduces bispectral index-guided requirements of propofol only during surgical stimulation. Br J Anaesth. 2010 Oct;105(4):471-9. doi: 10.1093/bja/aeq189. Epub 2010 Jul 21.
• Results Senturk M, Pembeci K, Menda F, Ozkan T, Gucyetmez B, Tugrul M, Camci E, Akpir K. Effects of intramuscular administration of lidocaine or bupivacaine on induction and maintenance doses of propofol evaluated by bispectral index. Br J Anaesth. 2002 Dec;89(6):849-52. doi: 10.1093/bja/aef287.
• Results Chen Z. The effects of isoflurane and propofol on intraoperative neurophysiological monitoring during spinal surgery. J Clin Monit Comput. 2004 Aug;18(4):303-8. doi: 10.1007/s10877-005-5097-5.
• Results Urban MK, Fields K, Donegan SW, Beathe JC, Pinter DW, Boachie-Adjei O, Emerson RG. A randomized crossover study of the effects of lidocaine on motor- and sensory-evoked potentials during spinal surgery. Spine J. 2017 Dec;17(12):1889-1896. doi: 10.1016/j.spinee.2017.06.024. Epub 2017 Jun 27.
• Results Kranke P, Jokinen J, Pace NL, Schnabel A, Hollmann MW, Hahnenkamp K, Eberhart LH, Poepping DM, Weibel S. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. Cochrane Database Syst Rev. 2015 Jul 16;(7):CD009642. doi: 10.1002/14651858.CD009642.pub2.
• Results Ibrahim A, Aly M, Farrag W. Effect of intravenous lidocaine infusion on long-term postoperative pain after spinal fusion surgery. Medicine (Baltimore). 2018 Mar;97(13):e0229. doi: 10.1097/MD.0000000000010229.
• Results Maheshwari K, Avitsian R, Sessler DI, Makarova N, Tanios M, Raza S, Traul D, Rajan S, Manlapaz M, Machado S, Krishnaney A, Machado A, Rosenquist R, Kurz A. Multimodal Analgesic Regimen for Spine Surgery: A Randomized Placebo-controlled Trial. Anesthesiology. 2020 May;132(5):992-1002. doi: 10.1097/ALN.0000000000003143.

Drugs

Indications