A survey on the use of intravenous lidocaine infusion for acute pain in Scottish Hospitals

Abstract

Introduction: Intravenous (IV) lidocaine infusions are increasingly used in the management of acute pain. They are particularly used in patients undergoing colorectal surgery, where they are also found to decrease rates of postoperative ileus. IV lidocaine has significant toxicity in overdose. There are no current national guidelines or standards on the provision of IV lidocaine infusions. We aimed to get a snapshot of current usage and usage practices in Scottish NHS Hospitals, to identify common themes and variations in practice. Methods: A survey designed by the authors was emailed to 20 Scottish NHS Hospitals with an acute pain team. These were then followed up by telephone, if necessary. Results: Of the 20 hospitals, 16 (80%) responded; 12 out of 16 (75%) of the responding hospitals either used IV lidocaine infusions for acute pain or were planning to use them in the near future. There was variability in practices regarding delivery device, prescriber grade, bolus dosing, length of infusion, location of infusion and use with other local anaesthetic (LA) infusions. Conclusions: A majority of Scottish NHS Hospitals use IV lidocaine infusions in the management of acute pain. There are some variations in current practice; standardising practices may decrease the risk of LA toxicity. A national guideline is recommended.