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Open Access 01-12-2021 | Heart Surgery | Research article

Lidocaine for postoperative pain after cardiac surgery: a systematic review

Authors: Michael R. Boswell, Rajat N. Moman, Melissa Burtoft, Harrison Gerdes, Jacob Martinez, Danielle J. Gerberi, Erica Wittwer, M. Hassan Murad, W. Michael Hooten

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Objective

Lidocaine is one of the most widely used local anesthetics with well-known pharmacological properties. The purpose of this systematic review is to investigate the effects of lidocaine on postoperative pain scores and recovery after cardiac surgery.

Methods

A comprehensive database search was conducted by a reference librarian for randomized clinical trials (RCT) from January 1, 1980 to September 1, 2019. Eligible study designs included randomized controlled trials of lidocaine for postoperative pain management in adults undergoing cardiac surgery. After removal of duplicates, 947 records were screened for eligibility and 3 RCTs met inclusion criteria.

Results

Sources of bias were identified in 2 of 3 RCTs. Lidocaine was administered intravenously, topically, and intrapleurally. Key findings included [1] 2% lidocaine placed topically on chest tube prior to intraoperative insertion was associated with significantly lower pain scores and lower cumulative doses of fentanyl; and [2] 2% lidocaine administered intrapleurally was associated with significantly lower pain scores and significant improvements in pulmonary mechanics. Lidocaine infusions were not associated with significant changes in pain scores or measures of recovery. No significant associations were observed between lidocaine and overall mortality, hospital length of stay or ICU length of stay. No data were reported for postoperative nausea and vomiting or arrhythmias.

Conclusions

Due to the favorable risk profile of topical lidocaine and the need for further advancements in the postoperative care of adults after cardiac surgery, topically administered lidocaine could be considered for incorporation into established postoperative recovery protocols.

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Title: Lidocaine for postoperative pain after cardiac surgery: a systematic review
Authors: Michael R. Boswell
Rajat N. Moman
Melissa Burtoft
Harrison Gerdes
Jacob Martinez
Danielle J. Gerberi
Erica Wittwer
M. Hassan Murad
W. Michael Hooten
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Heart Surgery
Postoperative Nausea and Vomiting
Heart Surgery
Fentanyl
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01549-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Lidocaine for postoperative pain after cardiac surgery: a systematic review

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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