Mechanisms of analgesia of intravenous lidocaine.
OBJECTIVE
Intravenous lidocaine has been used for several indications since the decade of 1960. Its multimodal mechanism of action was the objective of this review.


BACKGROUND
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.
Lauretti
Gabriela Rocha
GR
Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP/USP), Ribeirão Preto, SP. grlauret@fmrp.usp.br
D000698:Analgesia; D000779:Anesthetics, Local / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage*
D000779:Anesthetics, Local; D008012:Lidocaine