Effect of an intravenous infusion of lidocaine on cisatracurium-induced neuromuscular block duration: a randomized-controlled trial.
BACKGROUND
Intravenous lidocaine can be used intraoperatively for its analgesic and antihyperalgesic properties but local anaesthetics may also prolong the duration of action of neuromuscular blocking agents. We hypothesized that intravenous lidocaine would prolong the time to recovery of neuromuscular function after cisatracurium.


METHODS
Forty-two patients were enrolled in this randomized, double-blind, placebo-controlled study. Before induction, patients were administered either a 1.5 mg/kg bolus of intravenous lidocaine followed by a 2 mg/kg/h infusion or an equal volume of saline. Anaesthesia was induced and maintained using propofol and remifentanil infusions. After loss of consciousness, a 0.15 mg/kg bolus of cisatracurium was administered. No additional cisatracurium injection was allowed. Neuromuscular function was assessed every 20 s using kinemyography. The primary endpoint was the time to spontaneous recovery of a train-of-four (TOF) ratio ≥ 0.9.


RESULTS
The time to spontaneous recovery of a TOF ratio ≥ 0.9 was 94 ± 15 min in the control group and 98 ± 16 min in the lidocaine group (P=0.27).


CONCLUSIONS
No significant prolongation of spontaneous recovery of a TOF ratio ≥ 0.9 after cisatracurium was found in patients receiving intravenous lidocaine.
Hans
G A
GA
Department of Anaesthesia and Intensive Care Medicine, CHU of Liège, University of Liège, Belgium. g.hans@chu.ulg.ac.be
Defresne
A
A
Ki
B
B
Bonhomme
V
V
Kaba
A
A
Legrain
C
C
Brichant
J F
JF
Hans
P C
PC
D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000494:pharmacology*; D001279:Atracurium / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D004558:Electric Stimulation; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D015742:Propofol; D011446:Prospective Studies; D000077208:Remifentanil; D055815:Young Adult
D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D001279:Atracurium; D008012:Lidocaine; D000077208:Remifentanil; C101584:cisatracurium; D015742:Propofol