Intravenous lidocaine for postmastectomy pain treatment: randomized, blind, placebo controlled clinical trial.
OBJECTIVE
Postoperative pain treatment in mastectomy remains a major challenge despite the multimodal approach. The aim of this study was to investigate the analgesic effect of intravenous lidocaine in patients undergoing mastectomy, as well as the postoperative consumption of opioids.


METHODS
After approval by the Human Research Ethics Committee of the Instituto de Medicina Integral Prof. Fernando Figueira in Recife, Pernambuco, a randomized, blind, controlled trial was conducted with intravenous lidocaine at a dose of 3mg/kg infused over 1h in 45 women undergoing mastectomy under general anesthesia. One patient from placebo group was.


RESULTS
Groups were similar in age, body mass index, type of surgery, and postoperative need for opioids. Two of 22 patients in lidocaine group and three of 22 patients in placebo group requested opioid (p=0.50). Pain on awakening was identified in 4/22 of lidocaine group and 5/22 of placebo group (p=0.50); in the post-anesthetic recovery room in 14/22 and 12/22 (p=0.37) of lidocaine and placebo groups, respectively. Pain evaluation 24h after surgery showed that 2/22 and 3/22 patients (p=0.50) of lidocaine and placebo groups, respectively, complained of pain.


CONCLUSIONS
Intravenous lidocaine at a dose of 3mg/kg administered over a period of an hour during mastectomy did not promote additional analgesia compared to placebo in the first 24h, and has not decreased opioid consumption. However, a beneficial effect of intravenous lidocaine in selected and/or other therapeutic regimens patients cannot be ruled out.
Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil. Electronic address: taniacouceiro@yahoo.com.br.
Tania Cursino de Menezes
TC
Couceiro
Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil; Faculdade Pernambucana de Saúde (FBS), Recife, PE, Brazil.
Luciana Cavalcanti
LC
Lima
Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil.
Léa Menezes Couceiro
LM
Burle
Department of Neurology and Neurosurgery, Universidade Federal de Pernambuco, Recife, PE, Brazil.
Marcelo Moraes
MM
Valença
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000768:Anesthesia, General / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage*; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008012:Lidocaine
Anestésico local; Dor; Dor pós-operatória; Intravenous lidocaine; Lidocaína intravenosa; Local anesthetic; Pain; Postoperative pain; Tratamento; Treatment