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Systemic lidocaine in surgical procedures: effects beyond sodium channel blockade

Brinkrolf, Peter; Hahnenkamp, Klaus

Current Opinion in Anesthesiology: August 2014 - Volume 27 - Issue 4 - p 420–425
doi: 10.1097/ACO.0000000000000094
DRUGS IN ANESTHESIA: Edited by Klaus Hahnenkamp

Purpose of review This review presents current data on the systemic administration of lidocaine. The focus is on studies in the perioperative setting. In addition, there is a brief look at experimental data on the effect of lidocaine at the molecular level.

Recent findings Several recent randomized prospective studies have reported lower postoperative pain values and less opioid administration in lidocaine groups in comparison with control groups receiving NaCl. However, there are conflicting data particularly in relation to patients undergoing nonabdominal surgery and on effects on postoperative resumption of bowel motility and hospital discharge times. Unfortunately, hardly any studies have investigated the effects of systemic lidocaine in comparison with epidural anesthesia. At the molecular level, a number of receptors and signal transduction cascades have been identified.

Summary Positive effects on postoperative pain, as well as on bowel motility and hospital discharge time, have regularly been observed. However, contradictory findings have also been published. As almost all of the studies only include very small patient numbers, large multicenter investigations are needed.

Department of Anaesthesiology and Intensive Care Medicine, University Hospital Münster, Munster, Germany

Correspondence to Dr Peter Brinkrolf, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Münster, Albert-Schweizer-Campus 1, Geb. A1, 48149 Munster, Germany. Tel: +49 251 8347255; e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.