Gabriela Rocha Lauretti1. 1. Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP/USP), Ribeirão Preto, SP. grlauret@fmrp.usp.br
Abstract
BACKGROUND AND OBJECTIVES: Intravenous lidocaine has been used for several indications since the decade of 1960. Its multimodal mechanism of action was the objective of this review. CONTENTS: Mechanisms of action that diverge from the classical Na+ channel blockade, the differential action of intravenous lidocaine in central sensitization, and the analgesic and cytoprotective actions, as well as the different doses of intravenous lidocaine were reviewed. CONCLUSIONS: The final analgesic action of intravenous lidocaine is a reflection of its multifactorial action. It has been suggested that its central sensitization is secondary to a peripheral anti-hyperalgic action on somatic pain and central on neuropathic pain, which result on the blockade of central hyperexcitability. The intravenous dose should not exceed the toxic plasma concentration of 5 microg mL(-1); doses smaller than 5 mg kg(-1), administered slowly (30 minutes), under monitoring, are considered safe.
BACKGROUND AND OBJECTIVES: Intravenous lidocaine has been used for several indications since the decade of 1960. Its multimodal mechanism of action was the objective of this review. CONTENTS: Mechanisms of action that diverge from the classical Na+ channel blockade, the differential action of intravenous lidocaine in central sensitization, and the analgesic and cytoprotective actions, as well as the different doses of intravenous lidocaine were reviewed. CONCLUSIONS: The final analgesic action of intravenous lidocaine is a reflection of its multifactorial action. It has been suggested that its central sensitization is secondary to a peripheral anti-hyperalgic action on somatic pain and central on neuropathic pain, which result on the blockade of central hyperexcitability. The intravenous dose should not exceed the toxic plasma concentration of 5 microg mL(-1); doses smaller than 5 mg kg(-1), administered slowly (30 minutes), under monitoring, are considered safe.
Authors: Robert Chu; Nelly Umukoro; Tiashi Greer; Jacob Roberts; Peju Adekoya; Charles A Odonkor; Jonathan M Hagedorn; Dare Olatoye; Ivan Urits; Mariam Salisu Orhurhu; Peter Umukoro; Omar Viswanath; Jamal Hasoon; Alan D Kaye; Vwaire Orhurhu Journal: Psychopharmacol Bull Date: 2020-10-15
Authors: Janell Tully; Jai Won Jung; Anjana Patel; Alyson Tukan; Sameer Kandula; Allen Doan; Farnad Imani; Giustino Varrassi; Elyse M Cornett; Alan David Kaye; Omar Viswanath; Ivan Urits Journal: Anesth Pain Med Date: 2021-01-02