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Mechanisms of analgesia of intravenous lidocaine Lauretti GRRev Bras Anestesiol 2008[May]; 58 (3): 280-6BACKGROUND 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 microg mL(-1); doses smaller than 5 mg kg(-1), administered slowly (30 minutes), under monitoring, are considered safe.|*Analgesia[MESH]|Anesthetics, Local/*administration & dosage[MESH]|Humans[MESH]|Injections, Intravenous[MESH]|Lidocaine/*administration & dosage[MESH] |
