A survey of perioperative intravenous lidocaine use by anaesthetists in Australia and New Zealand.

Perioperative intravenous lidocaine administration by anaesthetists is purported to confer a variety of benefits across a range of surgical procedures. It remains unclear whether the available evidence regarding efficacy and safety is sufficient to influence Australasian practice broadly, and whethe...

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Publicado en:Anaesthesia & Intensive Care Vol. 48; no. 1; pp. 53 - 59
Autores principales: Bailey, Martin A, Toner, Andrew J, Corcoran, Tomas B
Formato: Journal Article
Publicado: Sage Publications Inc. Jan2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Sage Publications Inc.
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        atl: A survey of perioperative intravenous lidocaine use by anaesthetists in Australia and New Zealand.
      aug:
        au:
          Bailey, Martin A
          Toner, Andrew J
          Corcoran, Tomas B
        affil: Department of Anaesthesia and Intensive Care Medicine, Taranaki Base Hospital, New Plymouth, New Zealand
      sug:
        subj:
          Lidocaine Therapeutic Use
          Anesthetics, Local Therapeutic Use
          New Zealand
          Infusions, Intravenous
          Postoperative Pain
          Australia
      ab: Perioperative intravenous lidocaine administration by anaesthetists is purported to confer a variety of benefits across a range of surgical procedures. It remains unclear whether the available evidence regarding efficacy and safety is sufficient to influence Australasian practice broadly, and whether significant barriers to uptake exist. We therefore conducted a survey of Fellows of the Australian and New Zealand College of Anaesthetists to evaluate patterns of lidocaine use, and perceptions relating to benefit and safety. Of 979 survey invitations, 295 (30.1%) responded. Of these, 51.9% of anaesthetists incorporate lidocaine administration into their practice. Amongst users, the most common indication is open abdominal or pelvic surgery (88.9%), with the principal intent of reducing acute pain and opioid use (both 92.2%). Only 51% perceive lidocaine to have a role in the prevention of chronic post-surgical pain, and less than a third administer it for operations strongly linked to this condition. Nearly all (91%) users deliver the drug by intraoperative bolus and infusion, with the majority using doses between 1.0 and 1.5 mg/kg for both the bolus and the hourly infusion rate. When parallel local anaesthetic techniques are employed, 44.4% restrict the dose, 37.3% turn the lidocaine infusion off first and 15.7% make no modifications. Most respondents terminate infusions by the end of surgery (52.3%) or in the post-anaesthesia care unit (26.8%). Few deliver postoperative infusions without electrocardiographic monitoring (5.9%). There were no reports of life-threatening events. The dichotomy in Australasian use of perioperative lidocaine revealed by this survey confirms that large multicentre trials are now required to guide practice accurately.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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