Background and Aims Hip pathology surgery, is a major health problem due to the aging of the population, mortality, and secondary functional dependency. Patients experience moderate to severe pain after a hip surgery. Achieving optimal postoperative analgesia allows initiation of rehabilitation early. Intravenous opioid analgesia is effective for rest pain but inadequate for dynamic analgesia with side effects. There is a growing interest in the use of non-opioid adjuvant analgesics. A drug with great potential is lidocaine. Our objective is to evaluate the role of perioperative intravenous lidocaine in the reduction of pain and improvement of postoperative results in hip surgery.
Methods A literature review was performed in the PubMed database using the keywords ”intravenous lidocaine”, ”postoperative analgesia”, and ”hip surgery”. Articles and reviews from the last 5 years were included. Studies in children under 18 years of age and pregnant were excluded.
ResultsThe reported benefits are included in Tables 1 and 2. Effects occur at low plasma concentrations during the infusion and persist for hours and even days afterward. The main mechanism of action is the reduction of inflammatory markers (leukotrienes-B4 and interleukin-1). The antinociceptive and antihyperalgesic action is multifactorial (like muscarinic, dopaminergic, and NMDA receptors). Despite its scientific evidence in multiple interventions, especially abdominal and urological, its evidence in hip surgery is scarce (Table 3).
Conclusions Perioperative intravenous lidocaine is strongly recommended in a wide variety of surgeries as a postoperative analgesic technique. However, it is not recommended in hip surgery because of the scarcity of studies and their contradictions.
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