DOI: https://doi.org/10.22141/2224-0586.2.97.2019.161647

Lidocaine in multimodal anesthesia: a panacea of the present or a new fashion trend?

О.A. Loskutov, T.A. Danchyna, V.H. Kolesnykov, A.M. Druzhina

Abstract


The paper considers the action and the effectiveness of multimodal low-opioid anaesthesia with intravenous lidocaine in cardiac surgery. The study included 28 patients aged 69.5 ±
± 6.2 years who underwent coronary artery bypass grafting under artificial blood circulation. The patients received endotracheal anaesthesia. The induction was performed with propofol (1.52 ± 0.05 mg/kg), fentanyl (1–1.5 μg/kg), pipecuronium bromide (0.1 mg/kg), and lidocaine (1 mg/kg bolus) followed by the continuous infusion of lidocaine (1.5–2 mg/kg/h), sevoflurane (1.5–2 MAC), intravenous magnesium sulphate (30 mg/kg) and ketamine (0.5 mg/kg) once before the incision. The average dose of fentanyl used for the entire period of anesthesiology support was 1.09 ± 0.03 μg/kg/h (358.3 ± 27.1 μg for the duration of surgery). The mean pain level on visual analogue scale was 4.6 ± 1.2. At day one, 27.8 % of patients reported the maximum severity of pain, 72.2 % of individuals had medium or low pain. The offered regimen of low-opioid anaesthesia with intravenous lidocaine can ensure adequate analgesia. It allows refusing the intraoperative use of high doses of fentanyl during highly traumatic operations, as indicated by the absence of hemodynamic and endocrine-metabolic changes.


Keywords


multimodal low opioid anesthesia; intravenous lidocaine; coronary bypass

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