Journal article
Lidocaine for postoperative pain after cardiac surgery: a systematic review
Journal of cardiothoracic surgery, Vol.16(1), pp.1-157
05/31/2021
DOI: 10.1186/s13019-021-01549-0
PMCID: PMC8166031
PMID: 34059093
Abstract
Objective Lidocaine is one of the most widely used local anesthetics with well-known pharmacological properties. The purpose of this systematic review is to investigate the effects of lidocaine on postoperative pain scores and recovery after cardiac surgery. Methods A comprehensive database search was conducted by a reference librarian for randomized clinical trials (RCT) from January 1, 1980 to September 1, 2019. Eligible study designs included randomized controlled trials of lidocaine for postoperative pain management in adults undergoing cardiac surgery. After removal of duplicates, 947 records were screened for eligibility and 3 RCTs met inclusion criteria. Results Sources of bias were identified in 2 of 3 RCTs. Lidocaine was administered intravenously, topically, and intrapleurally. Key findings included [1] 2% lidocaine placed topically on chest tube prior to intraoperative insertion was associated with significantly lower pain scores and lower cumulative doses of fentanyl; and [2] 2% lidocaine administered intrapleurally was associated with significantly lower pain scores and significant improvements in pulmonary mechanics. Lidocaine infusions were not associated with significant changes in pain scores or measures of recovery. No significant associations were observed between lidocaine and overall mortality, hospital length of stay or ICU length of stay. No data were reported for postoperative nausea and vomiting or arrhythmias. Conclusions Due to the favorable risk profile of topical lidocaine and the need for further advancements in the postoperative care of adults after cardiac surgery, topically administered lidocaine could be considered for incorporation into established postoperative recovery protocols.
Details
- Title: Subtitle
- Lidocaine for postoperative pain after cardiac surgery: a systematic review
- Creators
- Michael R. Boswell - Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA.Rajat N. Moman - Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA.Melissa Burtoft - Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA.Harrison Gerdes - Mayo ClinicJacob Martinez - Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA.Danielle J. Gerberi - Mayo Clinic Library, Mayo Clinic, Rochester, USAErica Wittwer - Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA.M. Hassan Murad - Division of Preventative Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, USAW. Michael Hooten - Division of Pain Medicine, Mayo Clinic, Rochester, USA
- Resource Type
- Journal article
- Publication Details
- Journal of cardiothoracic surgery, Vol.16(1), pp.1-157
- DOI
- 10.1186/s13019-021-01549-0
- PMID
- 34059093
- PMCID
- PMC8166031
- NLM abbreviation
- J Cardiothorac Surg
- ISSN
- 1749-8090
- eISSN
- 1749-8090
- Publisher
- Springer Nature
- Number of pages
- 7
- Language
- English
- Date published
- 05/31/2021
- Academic Unit
- Anesthesia
- Record Identifier
- 9984296132902771
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