Table 3.
Literature review of the relevant trials evaluating the effects of intravenous lignocaine on intraoperative haemodynamics and anaesthetic requirements
| Author | Patients (n) | Type of surgery | Lignocaine | Trial design | Variable measured | Outcome (compared to control) | |
|---|---|---|---|---|---|---|---|
| Bolus dose | Infusion dose | ||||||
| Cassuto [25] | 20 | Elective Cholecystectomy | 100 mg | 2 mg/min/24 h | Single centre RCT | Intraoperative SBP | No significant differences |
| Intraoperative HR | No significant differences | ||||||
| Rimback [26] | 30 | Cholecystectomy | 100 mg | 3 mg/min for 24 h | Single centre RCT | SBP during first postoperative day | No significant differences |
| HR during first postoperative day | No significant differences | ||||||
| Ben-Shlomo [14] | 90 | Minor gynaecological surgery | 3 mg/kg (intramuscular) | None | Double blinded factorial RCT | Total dose of propofol required to achieve loss in response | 34.4% lower in the Lignocaine group (p < 0.001) |
| Waijma [23] | 25 | Electroconvulsive Therapy | 1.5 mg/kg | None | Double blinded RCT | MAP before and during electroconvulsive therapy | No significant differences |
| HR before and during electroconvulsive therapy | No significant differences | ||||||
| Kuo [20] | 60 | Elective colon surgery | 2 mg/kg | 3 mg/kg/h | Single centre, double blinded RCT | Mean end tidal desflurane concentration | 18% lower in Lignocaine group. (p < 0.1) |
| Kaba [21] | 40 | Laparoscopic colectomy | 1.5 mg/kg | 2 mg/kg/h until end of operation, then 1.33 mg/k/g/h for next 24 h | Single centre, double blinded RCT | Intraoperative MAP | Lower in the Lignocaine group (p = 0.03) |
| Intraoperative HR | Lower in the Lignocaine group (p = 0.002) | ||||||
| Mean end tidal sevoflurane concentration | 35% lower in the Lignocaine group (p < 0.001) | ||||||
| Saadawy [22] | 120 | Laparoscopic cholecystectomy | 2 mg/kg | 2 mg/kg/h for duration of surgery | Single centre, double blinded factorial RCT | MAP before induction, during operation, and in recovery | No significant differences |
| HR before induction, during operation, and in recovery | No significant differences | ||||||
| Mean end tidal sevoflurane concentration | 48% lower in the Lignocaine group (p < 0.001) | ||||||
| Altermatt [12] | 40 | Elective laparoscopic cholecystectomy | 1.5 mg/kg | 2 mg/kg/h | Double blinded RCT | Mean maintenance propofol dose | 17% lower in the Lignocaine group (p = 0.01) |
| Choi [18] | 60 | Breast plastic surgery | 1.5 mg/kg | 1.5 mg/kg/h | Single centre RCT | Mean intraoperative end tidal sevoflurane concentration | 5% lower in the Lignocaine group (p = 0.014) |
| Hamp [16] | 90 | Elective surgery | 1.5 mg/kg | None | Double blinded factorial RCT | Intraoperative mean alveolar concentration of sevoflurane | 12% lower in the Lignocaine group (p = 0.022) |
| 0.75 mg/kg | Intraoperative mean alveolar concentration of sevoflurane | No significant differences when compared with the Saline group | |||||
| Staikou [24] | 78 | Not specified | 1.5 mg/kg | None | Double blinded RCT | SBP and DBP before induction and during surgery | No significant differences |
| HR before induction and intraoperative | No significant differences | ||||||
| Weber [13] | 54 | Breast or orthopaedic surgery | 1.5 mg/kg | None | Double blinded factorial RCT | Mean intraoperative plasma level of propofol required to prevent a movement response in 50% of patients (Cp50) | 42% lower in the Lignocaine group (p < 0.05) |
| 0.5 mg/kg | Mean intraoperative Cp50 of propofol | No significant differences | |||||