Lidocaine

Anasthetic and class Ib antiarrhythmic agent.?Blocks voltage-gated sodium channels in the inactivated state.

[Effect of intravenous infusion with lidocaine on rapid recovery of laparoscopic cholecystectomy].[Pubmed:28355756]

Zhonghua Yi Xue Za Zhi. 2017 Mar 28;97(12):934-939.

Objective: To investigate the effect of intravenous infusion with Lidocaine on rapid recovery of laparoscopic cholecystectomy. Methods: This study was a prospective randomized controlled trial. From February to August 2016 in Affiliated Yiwu Hospital of Wenzhou Medical University, 60 patients scheduled for laparoscopic cholecystectomy under general anesthesia were involved and randomly divided into control group (n=30) and Lidocaine group (n=30). Patients in Lidocaine group received Lidocaine 1.5 mg/kg intravenously before induction and followed by 2.0 mg.kg(-1).h(-1) to the end of surgery. Patients in control group received equal volumes of saline intravenously. Anesthesia induction in both groups were given intravenous midazolam 0.03 mg/kg, sufentanil 0.2 mug/kg, propofol 2.0 mg/kg and cisatracuium 0.2 mg/kg. Anesthesia was maintained with propofol 0.05-0.20 mg.kg(-1).min(-1) and remifentanil 0.1-0.5 mug.kg(-1).min(-1) for laryngeal mask airway which bispectral index (BIS) value maintained at 40-60. BIS, heart rate(HR) and mean arterial pressure(MAP) were recorded before anesthesia induction, before and immediately after laryngeal mask implantation, intraoperative 30 min and anesthesia awake. Pain scores were assessed using visual analogue scales (VAS) at postoperation immediately, 30 min during postanesthesia care unit (PACU), 2, 6, 12, and 24 h after surgery. The time of PACU retention, postoperative ambulation, first intestine venting and discharge were recorded. The dosage of propofol and remifentanil, the frequency of sufentanil used, the incidence of postoperative nausea and vomiting were also recorded. Patient satisfaction was evaluated by using Simple Restoration Quality Score (QoR-9). Results: BIS values before and after laryngeal mask implantation in Lidocaine group were 50.50+/-3.47 and 54.63+/-1.25 respectively, which was lower than those in control group(54.30+/-4.78, 55.80+/-2.33; t=3.542, 2.423, all P<0.05). The VAS score at postoperation immediately, PACU 30 min, postoperative 2, 6, 12 h in Lidocaine group were 2.76+/-0.97, 2.37+/-0.93, 2.10+/-1.12, 1.76+/-0.97, 1.20+/-0.76 respectively, which was lower than those in control group (3.83+/-1.34, 3.27+/-1.26, 3.06+/-1.20, 2.63+/-0.88, 1.90+/-0.84; t=3.528, 3.154, 3.217, 3.603, 3.372, all P<0.05 ). The frequency of additional sufentanil at postoperation immediately and PACU 30 min in Lidocaine group was 5(17%), 3(10%), which were less than those in control group(12(40%), 9(30%); chi(2)=4.022, 3.950, all P<0.05). The dosage of propofol and remifentanil in Lidocaine group were (4.33+/-0.75) mg.kg(-1).h(-1) and (9.00+/-1.66) mug.kg(-1).h(-1) respectively, which were less than those in control group ((5.20+/-1.39) mg.kg(-1).h(-1) and (10.43+/-2.20) mug.kg(-1).h(-1;) t= 2.982, 2.842, all P<0.05). The time of PACU retention, postoperative ambulation and first intestine venting were (39.90 +/- 8.06) min, (11.93+/-1.68) h and (10.16+/-1.05) h respectively in Lidocaine group, which were shorter than those in control group ((48.23+/-10.04) min, (13.16+/-1.58) h and (11.13+/-1.30) h; t=3.514, 2.931, 3.156, all P<0.05). The QoR-9 score in Lidocaine group was 15.60+/-1.07, which was higher than that in control group(14.73+/-0.74, t=-3.649, P<0.05). There was no significant difference in the incidence of postoperative nausea/vomiting and the discharge time between two groups (all P>0.05). Conclusion: Intravenous infusion of Lidocaine can effectively reduce the dosages of propofol and remifentanil, postoperative early VAS score, postoperative ambulation time and first intestine venting time which could improve the satisfaction of patients.

Lidocaine gel versus plain lubricating gel for pain reduction during transrectal sonography (LIPS): A randomized controlled trial.[Pubmed:28342390]

Eur J Obstet Gynecol Reprod Biol. 2017 May;212:60-64.

OBJECTIVE: To compare the efficacy and safety of Lidocaine gel and plain lubricating gel in relieving pain during transrectal sonography (TRS) in patients with gynecologic problems. METHODS: A randomized controlled trial was conducted in 80 participants who were scheduled to undergo TRS. The participants were allocated into the Lidocaine gel group and the aqueous gel group at a 1:1 ratio. The intensity of pain during TRS based on the visual analogue scale (0-10 points) and the adverse events were assessed and compared between the two groups. RESULTS: The two groups had similar demographic characteristics. Between the Lidocaine and aqueous gel groups, there was no significant difference in the pain score at probe manipulation (4.04+/-2.14 vs. 4.21+/-2.79; P=0.868), as well as at baseline, probe insertion, and 5min after probe removal. The degree of acceptability of the sonographer also did not differ between the two groups. No acute and delayed adverse events was occurred. CONCLUSION: Intrarectal Lidocaine gel for TRS provides no analgesic benefit compared with aqueous gel.

The effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypasses surgery.[Pubmed:28367195]

Pak J Med Sci. 2017 Jan-Feb;33(1):177-181.

BACKGROUND AND OBJECTIVE: Pain control during surgery in order to cause analgesia and reduce the somatic and autonomic response may decrease the morbidity. Intrapleural catheter embedding during surgery under direct vision of surgeon is safe and easy and without potential risk of thoracic epidural block. The aim of this study was to investigate the effect of bilateral intrapleural infusion of Lidocaine with fentanyl versus only Lidocaine in relieving pain after coronary artery bypass surgery. METHODS: In this prospective randomized double blind clinical trial,130 adult patients undergoing elective CABG with age range of 20 to 60 years were divided into two groups receiving either Lidocaine and fentanyl (group A) or Lidocaine (group B). The analgesia was evaluated every two hours in all intubated and non-intubated patients using Visual analog scale (VAS) and data were analyzed using SPSS software package. RESULTS: Of all patients, 67 (51.5%) were males and 63 (48.5%) were females. The average age of subjects was 53.49 +/- 5.099 years. Mean pain score six hours after the surgery was statistically different between the groups at all times. CONCLUSION: The pain in patients receiving combination of Lidocaine and fentanyl is less than patients receiving only Lidocaine.

Lidocaine-loaded fish scale-nanocellulose biopolymer composite microneedles.[Pubmed:28353171]

AAPS PharmSciTech. 2017 Jul;18(5):1488-1494.

Microneedle (MN) technology has emerged as an effective drug delivery system, and it has tremendous potential as a patient friendly substitute for conventional methods for transdermal drug delivery (TDD). In this paper, we report on the preparation of Lidocaine-loaded biodegradable microneedles, which are manufactured from fish scale-derived collagen. Lidocaine, a common tissue numbing anaesthetic, is loaded in these microneedles with an aim of delivering the drug with controlled skin permeation. Evaluation of Lidocaine permeation in porcine skin has been successfully performed using Franz diffusion cell (FDC) which has shown that the drug permeation rate increases from 2.5 to 7.5% w/w after 36 h and pseudo steady state profile is observed from 5.0 to 10.0% w/w Lidocaine-loaded microneedle. Swelling experiments have suggested that the microneedles have negligible swellability which implies that the patch would stick to the tissue when inserted. The experiments on MN dissolution have depicted that the Lidocaine loaded in the patch is lower than the theoretical loading, which is expected as there can be losses of the drug during initial process manufacture.

Lidocaine (Lignocaine) inhibits sodium channels involving complex voltage and using dependence. Lidocaine decreases growth, migration and invasion of gastric carcinoma cells via up-regulating miR-145 expression and further inactivation of MEK/ERK and NF-κB signaling pathways. Lidocaine is an amide derivative commonly used to anesthetize. Lidocaine is a drug to treat ventricular arrhythmia and an effective tumor-inhibitor.

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