IV Lidocaine a Safe Opioid Alternative for Some ICU Patients?

Findings in patients in intensive care unit with varying degrees of organ dysfunction
Findings in patients in intensive care unit with varying degrees of organ dysfunction

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 online February 7 in the Journal of Clinical Pharmacology.

Yoonsun Mo, Pharm.D., 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 two hospitals. 

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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 six, 12, and 24 hours pre-IVLI compared with the same time periods after IVLI (18.3 versus 10 mg [P=0.002], 41.8 versus 18.3 mg [P=0.002], and 93.5 versus 30.5 mg [P=0.037], 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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