Perioperative intravenous lidocaine infusion for postoperative pain management: a integrative review

Abstract

Introduction: Perioperative intravenous lidocaine infusion is an approach adopted in the context of multimodal postoperative pain management, as a strategy to reduce opioid consumption and, consequently, minimize its adverse effects. Objective: To analyze the state of the art regarding the use of intravenous lidocaine and its mechanisms of systemic action, regarding its analgesic efficacy, pharmacokinetic safety, and associated adverse events. Methods: This study is an integrative review with an exploratory nature. The search was conducted in the following databases: PubMed, Web of Science, and Scielo and was guided by the following question: What is the potential of lidocaine for clinical use in postoperative pain management? Results: Positive impacts on pain relief, shorter hospital stays, and accelerated gastrointestinal recovery were demonstrated—with positive evidence in abdominal surgeries. Clinical safety depends on maintaining plasma concentrations within the therapeutic range (1.5– 5 µg/mL), with a significant risk of toxicity in patients with hepatic comorbidities, hypoalbuminemia, or obesity. Conclusion: Therefore, intravenous lidocaine represents a promising and cost-effective option, but it still requires further investigation and clearer definition of protocols for use.