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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
LAURETTI, Gabriela Rocha. Mechanisms of analgesia of intravenous lidocaine. Rev. Bras. Anestesiol. [online]. 2008, vol.58, n.3, pp. 280-286. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942008000300011.
BACKGROUND AND OBJECTIVES: Intravenous lidocaine has been used for several indications since the decade of 1960. Its multimodal mechanism of action was the objective of this review. CONTENTS: Mechanisms of action that diverge from the classical Na+ channel blockade, the differential action of intravenous lidocaine in central sensitization, and the analgesic and cytoprotective actions, as well as the different doses of intravenous lidocaine were reviewed. CONCLUSIONS: The final analgesic action of intravenous lidocaine is a reflection of its multifactorial action. It has been suggested that its central sensitization is secondary to a peripheral anti-hyperalgic action on somatic pain and central on neuropathic pain, which result on the blockade of central hyperexcitability. The intravenous dose should not exceed the toxic plasma concentration of 5 µg.mL-1; doses smaller than 5 mg.kg-1, administered slowly (30 minutes), under monitoring, are considered safe.
Keywords : ANALGESIA [lidocaine]; ANALGESIA [mechanisms of action]; ANALGESIA [intravenous].