PDF(418 KB)
![](\"/images/email.png\")
近年来，随着舒适化诊疗（comfort diagnostic and therapeutic procedure， CDTP）与医学人文理念不断发展，围手术期临床麻醉已逐渐形成多模式镇痛及低阿片化麻醉的趋向。术中静脉使用利多卡因可减少患者围手术期阿片类药物的暴露，降低恶心、呕吐、呼吸抑制等不良反应的发生风险，是加速康复外科（enhanced recovery after surgery，ERAS）发展的需要。本研究从药理学及代谢机制着手，归纳了近期术中静脉使用利多卡因的研究，从多模式镇痛角度综述了不同类型患者利多卡因静脉注射的利与弊。
","endNoteUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=EndNote&id=745","reference":"| 1 | Foo I， Macfarlane AJR， Srivastava D， et al. The use of intravenous lidocaine for postoperative pain and recovery： international consensus statement on efficacy and safety［J］. Anaesthesia， 2021， 76（2）： 238. |
| 2 | Dunn LK， Durieux ME. Perioperative use of intravenous lidocaine［J］. Anesthesiology， 2017， 126（4）： 729. |
| 3 | Beaussier M， Delbos A， Maurice-Szamburski A， et al. Perioperative use of intravenous lidocaine［J］. Drugs， 2018， 78（12）： 1229. |
| 4 | Lee IWS， Schraag S. The use of intravenous lidocaine in perioperative medicine： anaesthetic， analgesic and immune-modulatory aspects［J］. J Clin Med， 2022， 11（12）： 3543. |
| 5 | 中华医学会外科学分会. 中华医学会麻醉学分会.中国加速康复外科临床实践指南（2021）（一）［J］. 中华麻醉学杂志， 2021， 41（9）： 1028. |
| 6 | Hermanns H， Hollmann MW， Stevens MF， et al. Molecular mechanisms of action of systemic lidocaine in acute and chronic pain： a narrative review［J］. Br J Anaesth， 2019， 123（3）： 335. |
| 7 | Estebe JP. Intravenous lidocaine［J］. Best Pract Res Clin Anaesthesiol. 2017， 31（4）： 513. |
| 8 | Wagman IH， De Jong RH， Prince DA. Effects of lidocaine on the central nervous system［J］. Anesthesiology， 1967， 28（1）： 155. |
| 9 | Falconi-Sobrinho LL， Anjos-Garcia TD， Rebelo MA， et al. The anterior cingulate cortex and its interface with the dorsal periaqueductal grey regulating nitric oxide-mediated panic-like behaviour and defensive antinociception［J］. Neuropharmacology， 2024， 245： 109831. |
| 10 | Cui WH， Wang SS， Han RQ， et al. CaMKII phosphorylation in primary somatosensory cortical neurons is involved in the inhibition of remifentanil-induced hyperalgesia by lidocaine in male sprague-dawley rats［J］. J Neurosurg Anesthesiol， 2016， 28（1）： 44. |
| 11 | Piegeler T， Votta-Velis EG， Bakhshi FR， et al. Endothelial barrier protection by local anesthetics： ropivacaine and lidocaine block tumor necrosis factor-α-induced endothelial cell Src activation［J］. Anesthesiology， 2014， 120（6）： 1414. |
| 12 | Van Der Wal S， Vaneker M， Steegers M， et al. Lidocaine increases the anti-inflammatory cytokine IL-10 following mechanical ventilation in healthy mice［J］. Acta Anaesthesiol Scand， 2015， 59（1）： 47. |
| 13 | Song XL， Sun YX， Zhang XM， et al. Effect of perioperative intravenous lidocaine infusion on postoperative recovery following laparoscopic cholecystectomy-a randomized controlled trial［J］. Int J Surg， 2017， 45： 8. |
| 14 | Weinschenk S， Weiss C， Benrath J， et al. Anti-inflammatory characteristics of local anesthetics： inhibition of TNF-α secretion of lipopolysaccharide-stimulated leucocytes in human blood samples［J］. Int J Mol Sci， 2022， 23（6）： 3283. |
| 15 | Qi XJ， Lai ZP， Li S， et al. The efficacy of lidocaine in laryngospasm prevention in pediatric surgery： a network meta-analysis［J］. Sci Rep， 2016， 6： 32308. |
| 16 | Phuvachoterojanaphokin N， Watanaboonyongcharoen G， Jinawong S， et al. Low-dose lidocaine attenuates fentanyl-induced cough： a double-blind randomized controlled trial［J］. Eur J Clin Pharmacol， 2022， 78（5）： 813. |
| 17 | Arsyad A， Sokoya E， Dobson GP. Adenosine and lidocaine （AL） combination dilates intimally damaged rat thoracic aortic rings and guinea pig mesenteric arteries： possible significance to cardiac surgery［J］. Am J Transl Res， 2018， 10（6）： 1841. |
| 18 | 冯艺，许军军，中华医学会麻醉学分会中国全凭静脉麻醉临床实践指南（ 2024 版）编写组. 中国全凭静脉麻醉临床实践指南（2024版）［J］. 中华麻醉学杂志，2024，44（09）：1030. |
| 19 | Gustafsson UO， Scott MJ， Hubner M， et al. Guidelines for perioperative care in elective colorectal surgery： enhanced recovery after surgery （ERAS?） society recommendations： 2018［J］. World J Surg， 2019， 43（3）： 659. |
| 20 | Sakata RK， de Lima RC， Valad?o JA， et al. Randomized， double-blind study of the effect of intraoperative intravenous lidocaine on the opioid consumption and criteria for hospital discharge after bariatric surgery［J］. Obes Surg， 2020， 30（4）： 1189. |
| 21 | Ghimire B， Bahadur Chand M. Lidocaine for reduction of pain induced by propofol in a tertiary care hospital： a descriptive cross-sectional study［J］. JNMA J Nepal Med Assoc， 2021， 59（236）： 365. |
| 22 | Euasobhon P， Dej-Arkom S， Siriussawakul A， et al. Lidocaine for reducing propofol-induced pain on induction of anaesthesia in adults［J］. Cochrane Database Syst Rev， 2016， 2（2）： CD007874. |
| 23 | Zaazouee MS， Mahmoud AM， Elfar WH， et al. Effect of ondansetron compared to lidocaine and placebo for reducing propofol injection pain： a systematic review and meta-analysis of randomized controlled trials［J］. Medicine （Baltimore）， 2023， 102（38）： e35021. |
| 24 | Licina A， Silvers A. Perioperative intravenous lignocaine infusion for postoperative pain control in patients undergoing surgery of the spine： protocol for a systematic review and meta-analysis［J］. BMJ Open， 2020， 10（10）： e036908. |
| 25 | Rotella JA， Greene SL， Koutsogiannis Z， et al. Treatment for beta-blocker poisoning： a systematic review［J］. Clin Toxicol （Phila）， 2020， 58（10）： 943. |
| 26 | Martin RD， Scanlon M， McCabe K. Lidocaine-associated CNS toxicity at therapeutic dosage： a case report and literature review［J］. Cureus， 2024， 16（6）： e62231. |
| 27 | Greenwood E， Nimmo S， Paterson H， et al. Intravenous lidocaine infusion as a component of multimodal analgesia for colorectal surgery-measurement of plasma levels［J］. Perioper Med （Lond）， 2019， 8： 1. |
| 28 | Jayaprabhu NB， Avula J， Chandy TT， et al. A randomized controlled trial comparing intravenous lidocaine infusion with thoracic epidural for perioperative analgesia and quality of recovery after surgery in laparoscopic left-sided colon and sphincter-sparing rectal resection surgery［J］. Cureus， 2022， 14（4）： e23758. |
| 29 | Plass F， Nicolle C， Zamparini M， Al Issa G， Fiant AL， Le Roux Y， Gérard JL， Fischer MO， Alvès A， Hanouz JL. Effect of intra-operative intravenous lidocaine on opioid consumption after bariatric surgery： a prospective， randomised， blinded， placebo-controlled study. Anaesthesia. 2021 Feb；76（2）：189. |
| 30 | Paterson HM， Cotton S， Norrie J， et al. The ALLEGRO trial： a placebo controlled randomised trial of intravenous lidocaine in accelerating gastrointestinal recovery after colorectal surgery［J］. Trials， 2022， 23（1）： 84. |
| 31 | Peng H， Tang GP， Zhuang XQ， et al. Minimally invasive spine surgery decreases postoperative pain and inflammation for patients with lumbar spinal stenosis［J］. Exp Ther Med， 2019， 18（4）： 3032. |
| 32 | Wu Y， Chen ZM， Yao CM， et al. Effect of systemic lidocaine on postoperative quality of recovery， the gastrointestinal function， inflammatory cytokines of lumbar spinal stenosis surgery： a randomized trial［J］. Sci Rep， 2023， 13（1）： 17661. |
| 33 | Foong KW， Chaw SH， Lo YL， et al. Population pharmacokinetics of intravenous lidocaine in adults： a systematic review［J］. Clin Pharmacokinet， 2024， 63（5）： 623. |
| 34 | Onyeaka H， Adeola J， Xu R， et al. Intravenous lidocaine for the management of chronic pain： a narrative review of randomized clinical trials［J］. Psychopharmacol Bull， 2024， 54（3）： 73. |
)","risUrl_cn":"//www.pitakata.com/xuebao/CN/article/getTxtFile.do?fileType=Ris&id=745","title_cn":"术中静脉使用利多卡因的研究进展","doi":"10.3969/j.issn.2097-0005.2025.01.009","jieShuYe":"57","keywordList_en":["lidocaine","intravenous","multi-modal analgesia"],"endNoteUrl_cn":"//www.pitakata.com/xuebao/CN/article/getTxtFile.do?fileType=EndNote&id=745","zhaiyao_en":"In recent years， with the continuous development of comfort diagnostic and therapeutic procedure （CDTP） and the concept of medical humanism， the trend of multimodal analgesia and low opioid anesthesia has gradually emerged in perioperative clinical anesthesia. Intraoperative intravenous lidocaine can reduce patients' exposure to perioperative opioids and lower the risk of nausea， vomiting， respiratory depression， and other adverse reactions， which is needed to accelerate the development of enhanced recovery after surgery （ERAS）. In this study， we have summarized recent studies on the intraoperative intravenous use of lidocaine from the perspective of pharmacology and metabolic mechanisms， while reviewing the pros and cons of intravenous lidocaine in different types of patients from the perspective of multi-modal analgesia.
","bibtexUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=BibTeX&id=745","abstractUrl_cn":"http://xuebao.sdfmu.edu.cn/CN/10.3969/j.issn.2097-0005.2025.01.009","zuoZheCn_L":"周正, 王月兰","juanUrl_cn":"http://xuebao.sdfmu.edu.cn/CN/Y2025","lanMu_en":"Reviews","qiUrl_en":"http://xuebao.sdfmu.edu.cn/EN/Y2025/V46/I1","zuoZhe_EN":"Zheng ZHOU1,2, Yuelan WANG1()","risUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=Ris&id=745","title_en":"Research progress of intraoperative intravenous use of lidocaine","hasPdf":"true"},"authorNotes_cn":["王月兰，E-mail：wyldgf@163.com。
PDF(418 KB)
PDF(418 KB)
术中静脉使用利多卡因的研究进展
Research progress of intraoperative intravenous use of lidocaine
近年来，随着舒适化诊疗（comfort diagnostic and therapeutic procedure， CDTP）与医学人文理念不断发展，围手术期临床麻醉已逐渐形成多模式镇痛及低阿片化麻醉的趋向。术中静脉使用利多卡因可减少患者围手术期阿片类药物的暴露，降低恶心、呕吐、呼吸抑制等不良反应的发生风险，是加速康复外科（enhanced recovery after surgery，ERAS）发展的需要。本研究从药理学及代谢机制着手，归纳了近期术中静脉使用利多卡因的研究，从多模式镇痛角度综述了不同类型患者利多卡因静脉注射的利与弊。
In recent years， with the continuous development of comfort diagnostic and therapeutic procedure （CDTP） and the concept of medical humanism， the trend of multimodal analgesia and low opioid anesthesia has gradually emerged in perioperative clinical anesthesia. Intraoperative intravenous lidocaine can reduce patients' exposure to perioperative opioids and lower the risk of nausea， vomiting， respiratory depression， and other adverse reactions， which is needed to accelerate the development of enhanced recovery after surgery （ERAS）. In this study， we have summarized recent studies on the intraoperative intravenous use of lidocaine from the perspective of pharmacology and metabolic mechanisms， while reviewing the pros and cons of intravenous lidocaine in different types of patients from the perspective of multi-modal analgesia.
| 1 | Foo I， Macfarlane AJR， Srivastava D， et al. The use of intravenous lidocaine for postoperative pain and recovery： international consensus statement on efficacy and safety［J］.Anaesthesia，2021，76（2）： 238. |
| 2 | Dunn LK， Durieux ME. Perioperative use of intravenous lidocaine［J］.Anesthesiology，2017，126（4）： 729. |
| 3 | Beaussier M， Delbos A， Maurice-Szamburski A， et al. Perioperative use of intravenous lidocaine［J］.Drugs，2018，78（12）： 1229. |
| 4 | Lee IWS， Schraag S. The use of intravenous lidocaine in perioperative medicine： anaesthetic， analgesic and immune-modulatory aspects［J］.J Clin Med，2022，11（12）： 3543. |
| 5 | 中华医学会外科学分会. 中华医学会麻醉学分会.中国加速康复外科临床实践指南（2021）（一）［J］.中华麻醉学杂志，2021，41（9）： 1028. |
| 6 | Hermanns H， Hollmann MW， Stevens MF， et al. Molecular mechanisms of action of systemic lidocaine in acute and chronic pain： a narrative review［J］.Br J Anaesth，2019，123（3）： 335. |
| 7 | Estebe JP. Intravenous lidocaine［J］.Best Pract Res Clin Anaesthesiol.2017，31（4）： 513. |
| 8 | Wagman IH， De Jong RH， Prince DA. Effects of lidocaine on the central nervous system［J］.Anesthesiology，1967，28（1）： 155. |
| 9 | Falconi-Sobrinho LL， Anjos-Garcia TD， Rebelo MA， et al. The anterior cingulate cortex and its interface with the dorsal periaqueductal grey regulating nitric oxide-mediated panic-like behaviour and defensive antinociception［J］.Neuropharmacology，2024，245： 109831. |
| 10 | Cui WH， Wang SS， Han RQ， et al. CaMKII phosphorylation in primary somatosensory cortical neurons is involved in the inhibition of remifentanil-induced hyperalgesia by lidocaine in male sprague-dawley rats［J］.J Neurosurg Anesthesiol，2016，28（1）： 44. |
| 11 | Piegeler T， Votta-Velis EG， Bakhshi FR， et al. Endothelial barrier protection by local anesthetics： ropivacaine and lidocaine block tumor necrosis factor-α-induced endothelial cell Src activation［J］.Anesthesiology，2014，120（6）： 1414. |
| 12 | Van Der Wal S， Vaneker M， Steegers M， et al. Lidocaine increases the anti-inflammatory cytokine IL-10 following mechanical ventilation in healthy mice［J］.Acta Anaesthesiol Scand，2015，59（1）： 47. |
| 13 | Song XL， Sun YX， Zhang XM， et al. Effect of perioperative intravenous lidocaine infusion on postoperative recovery following laparoscopic cholecystectomy-a randomized controlled trial［J］.Int J Surg，2017，45： 8. |
| 14 | Weinschenk S， Weiss C， Benrath J， et al. Anti-inflammatory characteristics of local anesthetics： inhibition of TNF-α secretion of lipopolysaccharide-stimulated leucocytes in human blood samples［J］.Int J Mol Sci，2022，23（6）： 3283. |
| 15 | Qi XJ， Lai ZP， Li S， et al. The efficacy of lidocaine in laryngospasm prevention in pediatric surgery： a network meta-analysis［J］.Sci Rep，2016，6： 32308. |
| 16 | Phuvachoterojanaphokin N， Watanaboonyongcharoen G， Jinawong S， et al. Low-dose lidocaine attenuates fentanyl-induced cough： a double-blind randomized controlled trial［J］.Eur J Clin Pharmacol，2022，78（5）： 813. |
| 17 | Arsyad A， Sokoya E， Dobson GP. Adenosine and lidocaine （AL） combination dilates intimally damaged rat thoracic aortic rings and guinea pig mesenteric arteries： possible significance to cardiac surgery［J］.Am J Transl Res，2018，10（6）： 1841. |
| 18 | 冯艺，许军军，中华医学会麻醉学分会中国全凭静脉麻醉临床实践指南（2024版）编写组. 中国全凭静脉麻醉临床实践指南（2024版）［J］.中华麻醉学杂志，2024，44（09）：1030. |
| 19 | Gustafsson UO， Scott MJ， Hubner M， et al. Guidelines for perioperative care in elective colorectal surgery： enhanced recovery after surgery （ERAS?） society recommendations： 2018［J］.World J Surg，2019，43（3）： 659. |
| 20 | Sakata RK， de Lima RC， Valad?o JA， et al. Randomized， double-blind study of the effect of intraoperative intravenous lidocaine on the opioid consumption and criteria for hospital discharge after bariatric surgery［J］.Obes Surg，2020，30（4）： 1189. |
| 21 | Ghimire B， Bahadur Chand M. Lidocaine for reduction of pain induced by propofol in a tertiary care hospital： a descriptive cross-sectional study［J］.JNMA J Nepal Med Assoc，2021，59（236）： 365. |
| 22 | Euasobhon P， Dej-Arkom S， Siriussawakul A， et al. Lidocaine for reducing propofol-induced pain on induction of anaesthesia in adults［J］.Cochrane Database Syst Rev，2016，2（2）： CD007874. |
| 23 | Zaazouee MS， Mahmoud AM， Elfar WH， et al. Effect of ondansetron compared to lidocaine and placebo for reducing propofol injection pain： a systematic review and meta-analysis of randomized controlled trials［J］.Medicine （Baltimore），2023，102（38）： e35021. |
| 24 | Licina A， Silvers A. Perioperative intravenous lignocaine infusion for postoperative pain control in patients undergoing surgery of the spine： protocol for a systematic review and meta-analysis［J］.BMJ Open，2020，10（10）： e036908. |
| 25 | Rotella JA， Greene SL， Koutsogiannis Z， et al. Treatment for beta-blocker poisoning： a systematic review［J］.Clin Toxicol （Phila），2020，58（10）： 943. |
| 26 | Martin RD， Scanlon M， McCabe K. Lidocaine-associated CNS toxicity at therapeutic dosage： a case report and literature review［J］.Cureus，2024，16（6）： e62231. |
| 27 | Greenwood E， Nimmo S， Paterson H， et al. Intravenous lidocaine infusion as a component of multimodal analgesia for colorectal surgery-measurement of plasma levels［J］.Perioper Med （Lond），2019，8： 1. |
| 28 | Jayaprabhu NB， Avula J， Chandy TT， et al. A randomized controlled trial comparing intravenous lidocaine infusion with thoracic epidural for perioperative analgesia and quality of recovery after surgery in laparoscopic left-sided colon and sphincter-sparing rectal resection surgery［J］.Cureus，2022，14（4）： e23758. |
| 29 | Plass F， Nicolle C， Zamparini M， Al Issa G， Fiant AL， Le Roux Y， Gérard JL， Fischer MO， Alvès A， Hanouz JL. Effect of intra-operative intravenous lidocaine on opioid consumption after bariatric surgery： a prospective， randomised， blinded， placebo-controlled study.Anaesthesia.2021Feb；76（2）：189. |
| 30 | Paterson HM， Cotton S， Norrie J， et al. The ALLEGRO trial： a placebo controlled randomised trial of intravenous lidocaine in accelerating gastrointestinal recovery after colorectal surgery［J］.Trials，2022，23（1）： 84. |
| 31 | Peng H， Tang GP， Zhuang XQ， et al. Minimally invasive spine surgery decreases postoperative pain and inflammation for patients with lumbar spinal stenosis［J］.Exp Ther Med，2019，18（4）： 3032. |
| 32 | Wu Y， Chen ZM， Yao CM， et al. Effect of systemic lidocaine on postoperative quality of recovery， the gastrointestinal function， inflammatory cytokines of lumbar spinal stenosis surgery： a randomized trial［J］.Sci Rep，2023，13（1）： 17661. |
| 33 | Foong KW， Chaw SH， Lo YL， et al. Population pharmacokinetics of intravenous lidocaine in adults： a systematic review［J］.Clin Pharmacokinet，2024，63（5）： 623. |
| 34 | Onyeaka H， Adeola J， Xu R， et al. Intravenous lidocaine for the management of chronic pain： a narrative review of randomized clinical trials［J］.Psychopharmacol Bull，2024，54（3）： 73. |
/
| 〈 | 〉 |
