title: Intravenous lidocaine has no impact on rocuronium-induced neuromuscular block. Randomised study.
abstract: BACKGROUND
  Intravenous lidocaine is increasingly used in surgical patients. As it has neuromuscular blocking effects, we tested the impact of an intravenous lidocaine infusion on the time course of a rocuronium-induced neuromuscular block.
  
  
  METHODS
  Fifty-two adults undergoing surgery were randomly allocated to intravenous lidocaine 1.5 mg/kg followed by a continuous infusion of 2 mg/kg/h or physiological saline (control) throughout surgery. Anaesthesia was induced and maintained with a target-controlled propofol infusion and sufentanil. After loss of consciousness, rocuronium 0.6 mg/kg was given. Neuromuscular transmission was measured using train-of-four (TOF)-watch SX (Organon, Swords Co., Dublin, Ireland) acceleromyography.
  
  
  RESULTS
  Onset time (to 95% depression of first twitch) was on average 113.9 s (standard deviation 35.3) with lidocaine and 119.5 s (44.9) with saline (P = 0.618). Total recovery time (TOF ratio 0.9) was on average 58.1 min (15.1) with lidocaine and 54.3 min (16.9) with saline (P = 0.394). Clinical duration (until first twitch has recovered to 25%) was on average 33.3 min (7.2) with lidocaine and 30.6 min (8.1) with saline (P = 0.21). Recovery index (time between 25% and 75% recovery of the first twitch) was on average 11.5 min (5.0) with lidocaine and 10.6 min (4.1) with saline (P = 0.458). Recovery time (between 25% recovery of the first twitch and TOF ratio 0.9) was on average 24.8 min (9.3) with lidocaine and 23.2 min (9.2) with saline (P = 0.541).
  
  
  CONCLUSIONS
  A continuous intravenous infusion of lidocaine has no impact on the time course of the neuromuscular blockade induced by a standard intubation dose of rocuronium.
authors.affiliation: Division of Anaesthesiology, Geneva University Hospitals, Geneva, Switzerland. christoph.czarnetzki@hcuge.ch
authors.forename: C
authors.initials: C
authors.lastname: Czarnetzki
authors.forename: C
authors.initials: C
authors.lastname: Lysakowski
authors.forename: N
authors.initials: N
authors.lastname: Elia
authors.forename: M R
authors.initials: MR
authors.lastname: Tramèr
mesh_terms: D000328:Adult; D000732:Androstanols / Q000494:pharmacology*; D000779:Anesthetics, Local / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D000077123:Rocuronium
chemical_list: D000732:Androstanols; D000779:Anesthetics, Local; D003473:Neuromuscular Nondepolarizing Agents; D008012:Lidocaine; D000077123:Rocuronium