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Intravenous lidocaine for effective pain relief after bimaxillary surgery

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Abstract

Objectives

The aim of this prospective, randomized, double-blind, placebo-controlled study was to evaluate the analgesic effect of intravenous lidocaine on postoperative pain in bimaxillary surgery.

Materials and methods

Between July 2015 and November 2015, 52 consecutive patients that underwent bimaxillary surgery were recruited to the present study. The patients were randomly divided into two groups: group L (1.5 mg/kg bolus and 2 mg/kg/h continuous infusion during the operation) and group C (normal saline). To measure pain intensity, a visual analog scale (VAS) was used at 2, 4, 8, 12, 24, and 48 h after surgery. Rescue ketorolac use was measured in the first 4, 4–8, 8–24, and 24–48 h after surgery. Total ketorolac consumption (the sum of rescue and eight-hourly fixed schedule ketorolac injection), WBC count, neutrophil count, and postoperative swelling were recorded.

Results

There were no significant differences between the two groups with respect to demographics. VAS pain scores were significantly lower in group L compared with group C up to 8 h after surgery. Rescue ketorolac use up to 8 h after surgery and total ketorolac consumption were significantly lower in group L than in group C. Postoperative WBC and neutrophil counts were significantly decreased in group L. Compared with group C, the amount of calibrated postoperative swelling was lower in group L.

Conclusions

Systemic lidocaine infusion during bimaxillary surgery reduces postoperative pain, analgesic consumption, and facial swelling.

Clinical relevance

Systemic lidocaine is simple, economic, and a safe procedure reducing pain and soft tissue swelling after bimaxillary surgery.

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References

  1. Lee UL, Lee EJ, Seo HY, Han SH, Choi WC, Choi YJ (2016) Prevalence and risk factors of tooth discolouration after orthognathic surgery: a retrospective study of 1455 patients. Int J Oral Maxillofac Surg. doi:10.1016/j.ijom.2016.05.018

    Google Scholar 

  2. Alanko OM, Svedstrom-Oristo AL, Tuomisto MT (2010) Patients’ perceptions of orthognathic treatment, well-being, and psychological or psychiatric status: a systematic review. Acta Odontol Scand 68:249–260. doi:10.3109/00016357.2010.494618

    Article  PubMed  Google Scholar 

  3. Kalha A (2010) Orthognathic treatment and temporomandibular disorders—part 1. Evid Based Dent 11:82–83. doi:10.1038/sj.ebd.6400740

    Article  PubMed  Google Scholar 

  4. Magalhaes IB, Pereira LJ, Marques LS, Gameiro GH (2010) The influence of malocclusion on masticatory performance: a systematic review. Angle Orthod 80:981–987. doi:10.2319/011910-33.1

    Article  PubMed  Google Scholar 

  5. Nagatsuka C, Ichinohe T, Kaneko Y (2000) Preemptive effects of a combination of preoperative diclofenac, butorphanol, and lidocaine on postoperative pain management following orthognathic surgery. Anesth Prog 47:119–124

    PubMed  PubMed Central  Google Scholar 

  6. Niederhagen B, Braumann B, Dierke-Dzierzon C, Albrecht S (1997) Postoperative pain after interventions in the area of the mouth-jaw-face. Mund Kiefer Gesichtschir 1:229–234

    Article  PubMed  Google Scholar 

  7. Park YH, Choi YJ, Choi WC, Lee UL (2015) Partially withdrawn nasotracheal tube: an alternative to the nasal trumpet. Anesth Prog 62:166–167. doi:10.2344/15-00013.1

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kissin I (2000) Preemptive analgesia. Anesthesiology 93:1138–1143

    Article  PubMed  Google Scholar 

  9. Tuzuner AM, Ucok C, Kucukyavuz Z, Alkis N, Alanoglu Z (2007) Preoperative diclofenac sodium and tramadol for pain relief after bimaxillary osteotomy. J Oral Maxillofac Surg 65:2453–2458. doi:10.1016/j.joms.2007.06.622

    Article  PubMed  Google Scholar 

  10. Ahiskalioglu A, Ince I, Aksoy M, Yalcin E, Ahiskalioglu EO, Kilinc A (2016) Effects of a single-dose of pre-emptive pregabalin on postoperative pain and opioid consumption after double-jaw surgery: a randomized controlled trial. J Oral Maxillofac Surg 74(53):e1–e7. doi:10.1016/j.joms.2015.09.008

    Google Scholar 

  11. Woolf CJ, Chong MS (1993) Preemptive analgesia—treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg 77:362–379

    Article  PubMed  Google Scholar 

  12. Koppert W, Ostermeier N, Sittl R, Weidner C, Schmelz M (2000) Low-dose lidocaine reduces secondary hyperalgesia by a central mode of action. Pain 85:217–224

    Article  PubMed  Google Scholar 

  13. Kawamata M, Takahashi T, Kozuka Y, Nawa Y, Nishikawa K, Narimatsu E, Watanabe H, Namiki A (2002) Experimental incision-induced pain in human skin: effects of systemic lidocaine on flare formation and hyperalgesia. Pain 100:77–89

    Article  PubMed  Google Scholar 

  14. McCarthy GC, Megalla SA, Habib AS (2010) Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. Drugs 70:1149–1163. doi:10.2165/10898560-000000000-00000

    Article  PubMed  Google Scholar 

  15. Herroeder S, Pecher S, Schonherr ME, Kaulitz G, Hahnenkamp K, Friess H, Bottiger BW, Bauer H, Dijkgraaf MG, Durieux ME, Hollmann MW (2007) Systemic lidocaine shortens length of hospital stay after colorectal surgery: a double-blinded, randomized, placebo-controlled trial. Ann Surg 246:192–200. doi:10.1097/SLA.0b013e31805dac11

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kang H, Kim BG (2011) Intravenous lidocaine for effective pain relief after inguinal herniorrhaphy: a prospective, randomized, double-blind, placebo-controlled study. J Int Med Res 39:435–445

    Article  PubMed  Google Scholar 

  17. Kim TH, Kang H, Hong JH, Park JS, Baek CW, Kim JY, Jung YH, Kim HK (2011) Intraperitoneal and intravenous lidocaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study. Surg Endosc 25:3183–3190. doi:10.1007/s00464-011-1684-3

    Article  PubMed  Google Scholar 

  18. De Oliveira GS, Jr FP, Streicher LF, Marcus RJ, RJ MC (2012) Systemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery. Anesth Analg 115:262–267. doi:10.1213/ANE.0b013e318257a380

    Article  PubMed  Google Scholar 

  19. Grady P, Clark N, Lenahan J, Oudekerk C, Hawkins R, Nezat G, Pellegrini JE (2012) Effect of intraoperative intravenous lidocaine on postoperative pain and return of bowel function after laparoscopic abdominal gynecologic procedures. Aana j 80:282–288

    PubMed  Google Scholar 

  20. Kim KT, Cho DC, Sung JK, Kim YB, Kang H, Song KS, Choi GJ (2014) Intraoperative systemic infusion of lidocaine reduces postoperative pain after lumbar surgery: a double-blinded, randomized, placebo-controlled clinical trial. Spine J 14:1559–1566. doi:10.1016/j.spinee.2013.09.031

    Article  PubMed  Google Scholar 

  21. Phillips C, Blakey G 3rd, Jaskolka M (2008) Recovery after orthognathic surgery: short-term health-related quality of life outcomes. J Oral Maxillofac Surg 66:2110–2115. doi:10.1016/j.joms.2008.06.080

    Article  PubMed  PubMed Central  Google Scholar 

  22. Oncul AM, Cimen E, Kucukyavuz Z, Cambazoglu M (2011) Postoperative analgesia in orthognathic surgery patients: diclofenac sodium or paracetamol? Br J Oral Maxillofac Surg 49:138–141. doi:10.1016/j.bjoms.2010.04.017

    Article  PubMed  Google Scholar 

  23. Nooh N, Abdelhalim AA, Abdullah WA, Sheta SA (2013) Effect of remifentanil on the hemodynamic responses and recovery profile of patients undergoing single jaw orthognathic surgery. Int J Oral Maxillofac Surg 42:988–993. doi:10.1016/j.ijom.2013.02.001

    Article  PubMed  Google Scholar 

  24. Geha H, Nimeskern N, Beziat JL (2009) Patient-controlled analgesia in orthognathic surgery: evaluation of the relationship to anxiety and anxiolytics. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:e33–e36. doi:10.1016/j.tripleo.2009.05.027

    Article  PubMed  Google Scholar 

  25. Precious DS, Multari J, Finley GA, McGrath P (1997) A comparison of patient-controlled and fixed schedule analgesia after orthognathic surgery. J Oral Maxillofac Surg 55:33–39 discussion 40

    Article  PubMed  Google Scholar 

  26. Widar F, Kashani H, Alsen B, Dahlin C, Rasmusson L (2015) The effects of steroids in preventing facial oedema, pain, and neurosensory disturbances after bilateral sagittal split osteotomy: a randomized controlled trial. Int J Oral Maxillofac Surg 44:252–258. doi:10.1016/j.ijom.2014.08.002

    Article  PubMed  Google Scholar 

  27. Amir R, Argoff CE, Bennett GJ, Cummins TR, Durieux ME, Gerner P, Gold MS, Porreca F, Strichartz GR (2006) The role of sodium channels in chronic inflammatory and neuropathic pain. J Pain 7:S1–29. doi:10.1016/j.jpain.2006.01.444

    Article  PubMed  Google Scholar 

  28. Rowland M, Thomson PD, Guichard A, Melmon KL (1971) Disposition kinetics of lidocaine in normal subjects. Ann N Y Acad Sci 179:383–398

    Article  PubMed  Google Scholar 

  29. Werdehausen R, Kremer D, Brandenburger T, Schlosser L, Jadasz J, Kury P, Bauer I, Aragon C, Eulenburg V, Hermanns H (2012) Lidocaine metabolites inhibit glycine transporter 1: a novel mechanism for the analgesic action of systemic lidocaine? Anesthesiology 116:147–158. doi:10.1097/ALN.0b013e31823cf233

    Article  PubMed  Google Scholar 

  30. Han JB, Keller EE, Grothe RM (2014) Postoperative gastrointestinal bleeding in orthognathic surgery patients: its estimated prevalence and possible association to known risk factors. J Oral Maxillofac Surg 72:2043–2051. doi:10.1016/j.joms.2014.02.039

    Article  PubMed  Google Scholar 

  31. Hernandez-Diaz S, Rodriguez LA (2001) Steroids and risk of upper gastrointestinal complications. Am J Epidemiol 153:1089–1093

    Article  PubMed  Google Scholar 

  32. Herroeder S, Durieux ME, Hollmann MW (2002) Inflammatory responses after surgery. Hosp Med 63:99–103

    Article  PubMed  Google Scholar 

  33. MacGregor RR, Thorner RE, Wright DM (1980) Lidocaine inhibits granulocyte adherence and prevents granulocyte delivery to inflammatory sites. Blood 56:203–209

    PubMed  Google Scholar 

  34. Tozzi U, Santagata M, Sellitto A, Tartaro GP (2016) Influence of Kinesiologic tape on post-operative swelling after orthognathic surgery. J Maxillofac Oral Surg 15:52–58. doi:10.1007/s12663-015-0787-0

    Article  PubMed  Google Scholar 

  35. Chegini S, Dhariwal DK (2012) Review of evidence for the use of steroids in orthognathic surgery. Br J Oral Maxillofac Surg 50:97–101. doi:10.1016/j.bjoms.2010.11.019

    Article  PubMed  Google Scholar 

  36. Dan AE, Thygesen TH, Pinholt EM (2010) Corticosteroid administration in oral and orthognathic surgery: a systematic review of the literature and meta-analysis. J Oral Maxillofac Surg 68:2207–2220. doi:10.1016/j.joms.2010.04.019

    Article  PubMed  Google Scholar 

  37. Kim K, Brar P, Jakubowski J, Kaltman S, Lopez E (2009) The use of corticosteroids and nonsteroidal antiinflammatory medication for the management of pain and inflammation after third molar surgery: a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:630–640. doi:10.1016/j.tripleo.2008.11.005

    Article  PubMed  Google Scholar 

  38. Schaberg SJ, Stuller CB, Edwards SM (1984) Effect of methylprednisolone on swelling after orthognathic surgery. J Oral Maxillofac Surg 42:356–361

    Article  PubMed  Google Scholar 

  39. Shetty V, Mohan A (2013) A prospective, randomized, double-blind, placebo-controlled clinical trial comparing the efficacy of systemic enzyme therapy for edema control in orthognathic surgery using ultrasound scan to measure facial swelling. J Oral Maxillofac Surg 71:1261–1267. doi:10.1016/j.joms.2013.01.008

    Article  PubMed  Google Scholar 

  40. Gasperini G, Rodrigues de Siqueira IC, Rezende Costa L (2014) Does low-level laser therapy decrease swelling and pain resulting from orthognathic surgery? Int J Oral Maxillofac Surg 43:868–873. doi:10.1016/j.ijom.2014.02.015

    Article  PubMed  Google Scholar 

  41. Hwang HS, Choe SY, Hwang JS, Moon DN, Hou Y, Lee WJ, Wilkinson C (2015) Reproducibility of facial soft tissue thickness measurements using cone-beam CT images according to the measurement methods. J Forensic Sci 60:957–965. doi:10.1111/1556-4029.12766

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06911, Republic of Korea

    Uilyong Lee & Young-Jun Choi

  2. Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06911, Republic of Korea

    Geun Joo Choi & Hyun Kang

Authors
  1. Uilyong Lee
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  2. Young-Jun Choi
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  4. Hyun Kang
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Corresponding author

Correspondence to Hyun Kang.

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Conflict of interest

The authors declare that they have no competing interests.

Funding

None.

Ethical approval

The study protocol was approved by the Ethics Committee of Chung-Ang University Hospital (IRB no. C2015021(1479)), and all procedures performed in this study were in accordance with the ethical standards of the institutional research committee.

This study was carried out according to the principles of the Declaration of Helsinki, 2013.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Lee, U., Choi, YJ., Choi, G.J. et al. Intravenous lidocaine for effective pain relief after bimaxillary surgery. Clin Oral Invest 21, 2645–2652 (2017). https://doi.org/10.1007/s00784-017-2066-6

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  • DOI: https://doi.org/10.1007/s00784-017-2066-6

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