Reference : Intravenous lidocaine infusion reduces bispectral index-guided requirements of propof...
Scientific journals : Article
Human health sciences : Anesthesia & intensive care
http://hdl.handle.net/2268/79178
Intravenous lidocaine infusion reduces bispectral index-guided requirements of propofol only during surgical stimulation.
English
Hans, Grégory mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Lauwick, Séverine mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Kaba, Abdourahmane mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Bonhomme, Vincent mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Struys, M M R F [> > > >]
Hans, Pol [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Lamy, Maurice mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Joris, Jean mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
21-Jul-2010
British Journal of Anaesthesia
Oxford University Press
105
4
471-9
Yes (verified by ORBi)
International
0007-0912
1471-6771
Oxford
United Kingdom
[en] Anaesthetic ; Propofol ; Remifentanil ; Anaesthetic depth ; Bispectral index ; Haemodynamics ; Local anaesthetic ; i.v. lidocaine
[en] BACKGROUND: I.V. lidocaine reduces volatile anaesthetics requirements during surgery. We hypothesized that lidocaine would also reduce propofol requirements during i.v. anaesthesia. METHODS: A randomized controlled study of 40 patients tested the effect of i.v. lidocaine (1.5 mg kg(-1) then 2 mg kg(-1) h(-1)) on propofol requirements. Anaesthesia was maintained with remifentanil and propofol target-controlled infusions (TCI) to keep the bispectral index (BIS) around 50. Effect-site concentrations of propofol and remifentanil and BIS values were recorded before and after skin incision. Data were analysed using anova and mixed effects analysis with NONMEM. Two dose-response studies were then performed with and without surgical stimulation. Propofol TCI titrated to obtain a BIS around 50 was kept constant. Then patients were randomized into four groups: A, saline; B, 0.75 mg kg(-1) bolus then infusion 1 mg kg(-1) h(-1); C, 1.5 mg kg(-1) bolus and infusion 2 mg kg(-1) h(-1); and D, 3 mg kg(-1) bolus and infusion 4 mg kg(-1) h(-1). Lidocaine administration coincided with skin incision. BIS values and haemodynamic variables were recorded. Data were analysed using linear regression and two-way anova. RESULTS: Lidocaine decreased propofol requirements (P<0.05) only during surgery. In the absence of surgical stimulation, lidocaine did not affect BIS nor haemodynamic variables, whereas it reduced BIS increase (P=0.036) and haemodynamic response (P=0.006) secondary to surgery. CONCLUSIONS: The sparing effect of lidocaine on anaesthetic requirements seems to be mediated by an anti-nociceptive action.
http://hdl.handle.net/2268/79178
10.1093/bja/aeq189

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