Lidocaine Safe, Effective for Pain in the ICU

HealthDay News — Intravenous lidocaine (IVLI) seems safe for reducing pain among patients in the intensive care unit (ICU) with varying degrees of organ dysfunction, according to research published in the Journal of Clinical Pharmacology.1

Yoonsun Mo, PharmD, from Long Island University in Brooklyn, NY, and colleagues conducted a retrospective chart review to examine the safety and effectiveness of IVLI for the treatment of pain in ICU patients with varying degrees of organ dysfunction. Data were included for 21 ICU patients from 2 hospitals.

The researchers found that the mean time to a ≥20% reduction in pain scores was 3.3 hours from the start of IVLI. The median morphine dose equivalents were significantly higher during 6, 12, and 24 hours pre-IVLI compared with the same time periods after IVLI (18.3 vs 10 mg [P =.002], 41.8 vs 18.3 mg [P =.002], and 93.5 vs 30.5 mg [P =.037], respectively). Three patients experienced neurological adverse effects of lidocaine, but these were reversed on discontinuation of IVLI.

“This report suggests that IVLI as an adjunctive agent in the treatment of acute pain may be a potential option in ICU patients who are refractory to opioids or those in whom opioid-induced respiratory depression is a concern,” the authors write.

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  1. Mo Y, Thomas MC, Antigua AD, Ebied AM, Karras GE. Continuous Lidocaine Infusion as Adjunctive Analgesia in Intensive Care Unit Patients. J Clin Pharmacol. 2017. doi: 10.1002/jcph.874