Introduction:
In the treatment of acute postoperative pain, multimodal analgesia ideas and therapeutic approaches are currently being developed. It is crucial to recognize acute hyperalgesia since doing so increases the effectiveness and safety of treating acute pain. In the management of acute hyperalgesia, intravenous Lidocaine is a helpful therapy choice. Intravenous (IV) Lidocaine is frequently used for the effect it has on postoperative pain and healing, but when used improperly and wrongly, it can be lethal. The risk-benefit ratio of intravenous Lidocaine varies depending on the kind of operation and patient characteristics, including comorbidities (including pre-existing chronic pain).
What Is Intravenous Lidocaine Infusion?
A medical treatment called an intravenous Lidocaine infusion involves injecting the local anesthetic and antiarrhythmic drug Lidocaine directly into a vein. Due to its numbing properties and capacity to regulate abnormal cardiac rhythms, Lidocaine is a regularly utilized medication for a variety of medical procedures. In this procedure, a local anesthetic called intravenous Lidocaine infusion is given into a vein over the course of around 60 minutes using a pump. Due to its proven effectiveness, pain specialists recommend it to individuals who have endured generalized, chronic pain.
What Is Lidocaine?
The local anesthetic drug Lidocaine is frequently used for local and topical anesthesia, but it also possesses antiarrhythmic and analgesic properties and can be utilized as a tracheal intubation adjunct. As a perioperative analgesic, intravenous Lidocaine is utilized in a variety of settings, including the operating room, recovery area, intensive care unit (ICU), and surgical ward. In contrast to a direct local anesthetic effect, Lidocaine possesses anti-nociceptive (that inhibits the pain sensation), anti-hyperalgesic (that inhibits extreme sensitivity to pain), and anti-inflammatory properties, and it is likely these properties account for the apparent effect that persists hours after an infusion has ended.
What Happens During an Intravenous Lidocaine Infusion?
A cardiac monitor will be used to keep a close eye on the patient as they get the Lidocaine infusion. They will also have their respiration, pulse, and blood pressure periodically monitored. After the session, the doctors will discharge them and allow them to go back home if they have no significant adverse effects.
A patient will not know how effective the therapy has been for them on the day of the infusion because it takes several days for the medicine to take effect. Keeping a daily 'pain diary' is a good idea since it may serve as a brief record that can be given to the pain consultant at each in-person or online meeting. Their pain consultant will schedule a follow-up visit to see how effective it has been.
What Results Are Expected From Intravenous Lidocaine Infusion Process?
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The intravenous Lidocaine infusion is used to evaluate the possible effectiveness of Lidocaine and associated drugs in treating pain. Depending on the precise source of the pain, some people experience both rapid and long-lasting pain relief after receiving Lidocaine intravenously. Other people who have discomfort for various causes report that it takes them a while to feel better and that it can last only as long as the drug is being injected.
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Another proportion of individuals getting intravenous Lidocaine reports unfavorable or counterproductive effects from the medication. However, before the surgery is done, the medical professionals have no way of knowing to which category the patient could belong.
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The evaluating doctors may request that the patient keep a close eye on how long the benefits of intravenous Lidocaine infusion last and report this to them over the phone after the patient leaves the pain management center or when they are due for the next appointment for additional evaluation or treatment. Additionally, they should describe any notable reduction in pain or alteration in how the pain feels while receiving the infusion.
What Are the Clinical Applications of Intravenous Lidocaine Infusion?
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Cardiothoracic Surgery - Patients having thoracic surgery were found to benefit from perioperative Lidocaine infusion, which decreased pain ratings and narcotic use in the PACU (post-anesthesia care unit) and for up to six hours following surgery. Based on this trial, it was concluded that Lidocaine could be useful for thoracic surgery patients who are not neuraxial analgesia (local anesthetic injections into or near the central nervous system like spinal and epidural anesthesia) candidates.
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Abdominal Surgery - For patients having open and laparoscopic abdominal surgeries, including colectomy (colon removal), cholecystectomy (gallbladder removal), and appendectomy (appendix removal), the use of perioperative Lidocaine infusion may be beneficial, with advantages including a minor but considerable reduction in opioid consumption. Colorectal surgery shortens the hospital stay and could help with a faster recovery. Perioperative IV Lidocaine infusion has shown good results in bariatric (obese) patients, as the respiratory depressive effects of opioids are particularly sensitive for these people.
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Genitourinary Surgery - In patients undergoing various genitourinary surgeries, it was seen that intravenous Lidocaine infusion decreased the consumption of painkillers as well as the pain scores.
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Breast Surgery - Intravenous Lidocaine infusion showed beneficial results for patients undergoing mastectomy.
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Ambulatory Surgery - Patients having ambulatory surgical procedures (a surgery where there is no need for the patients to get admitted) may benefit from perioperative Lidocaine infusion to lessen their need for narcotic painkillers and speed up recovery and discharge. However, more research is needed keeping in view that different groups of patients respond differently to surgeries.
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Clinical Trials - Various trials are being conducted to know the impact of intravenous Lidocaine infusion in various surgical procedures and surgical setups.
What Are the Side Effects of Intravenous Lidocaine Infusion?
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When the treatment is over, there are often no repercussions from the intravenous infusion of Lidocaine. Due to the nature of this process, patients will experience the medication's full effects while being closely monitored by the doctors and personnel of the pain management center.
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Fortunately, major adverse effects or complications are quite uncommon, and since the patients are closely watched by health personnel, the likelihood of developing such issues is reduced. Sometimes after receiving an intravenous Lidocaine infusion, patients do experience some strange symptoms for a while. Generalized exhaustion, ongoing dizziness, or a headache are a few examples of these sensations. When the infusion is slowed down or stopped, if any of these adverse effects do arise, they frequently fade away.
Conclusion:
Lidocaine infusion has yielded encouraging findings, further investigations are necessary to completely comprehend its efficacy, safety, and ideal use. More thorough clinical trials are required to determine its role in various clinical settings because the evidence foundation for its usage in some disorders is still developing. In conclusion, intravenous Lidocaine infusion is a method that shows promise for the treatment of particular cardiac diseases as well as pain management. In some circumstances, it can offer effective treatment, but it is crucial to carefully choose patients, monitor them, and take potential hazards into account. As with any medical procedure, it is essential to seek the advice of medical experts who can assess specific cases and decide whether intravenous Lidocaine infusion is necessary as a component of an all-encompassing treatment strategy.
