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Perioperative lidocaine infusion for hip arthroplasty linked with decreased pain and opioid use

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Opioid consumption and pain decreased in patients who underwent primary hip arthroplasty and received perioperative lidocaine infusion, according to results presented at the Regional Anesthesiology and Acute Pain Medicine Meeting.

Researchers randomly assigned 20 primary hip arthroplasty patients to receive either standard anesthesia care combined with an intraoperative infusion of lidocaine or saline placebo. Investigators monitored pain scores and consumption of pain medication for 24 hours postoperatively. For an analysis with mass cytometry, whole blood was collected 1 hour and 24 hours postoperatively. Cell type-specific markers helped identify individual immune cell types and intracellular phosphorylation and signaling network activation. Cell type-specific intracellular cytokine production was assessed with a panel of intracellular and extracellular markers.

Results showed the average postoperative pain decreased by 30% with the lidocaine infusion. Investigators noted that after surgery, the maximum pain decreased by 48% and total opioid use decreased by 39%. The lidocaine plasma concentrations on average were 1.6 mcg/ml. Lidocaine-specific intracellular signaling profiles were identified with mass cytometry analysis.

“In particular, classical monocytes showed a decreased capacity to produce the pro-inflammatory cytokine interleukin 6 (IL-6) in post-surgical samples (arcshinh -1.5, P=0.02), while postsurgical phosphorylation of STAT3 (a key transcription factor activated by IL-6) and [nuclear factor kappa-light-chain-enhancer of activated B cells] NFkB were reduced across multiple monocyte populations,” the authors wrote in the study abstract. – by Monica Jaramillo

References:

Baca Q, et al. Abstract 7368. Presented at: Regional Anesthesiology and Acute Pain Medicine Meeting; April 11-13, 2019; Las Vegas.

www.newswise.com/articles/view/710511/?sc=dwhr&xy=10007438

Disclosure: Baca reports no relevant financial disclosures.