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Letter to the Editor|Articles in Press

“Can” Is Not “Should”: A Response to The Use of Intravenous Lidocaine as an Analgesic Modality in the Austere Environment by Dryden et al

Published:February 21, 2023DOI:https://doi.org/10.1016/j.wem.2023.01.004
      It was with great interest that we read the report by Dryden et al
      • Dryden B.
      • Kerr W.B.
      • Higgins S.
      • Tou K.
      • Dhanjal S.T.
      The use of intravenous lidocaine as an analgesic modality in the austere environment: two cases.
      regarding their use of intravenous (IV) lidocaine to treat acute pain due to musculoskeletal injury in an austere setting, as there is no precedent for out-of-hospital IV lidocaine administration for acute pain that we can identify. Treatment of pain is often overlooked, and can be critical to facilitating procedures or patient evacuations. Given the range of available modalities, it can be as much art as science.
      • Russell K.W.
      • Scaife C.L.
      • Weber D.C.
      • Windsor J.S.
      • Wheeler A.R.
      • Smith W.R.
      • et al.
      Wilderness Medical Society practice guidelines for the treatment of acute pain in remote environments: 2014 update.
      Appropriate investigation of new applications of classic pain control medications, such as the use of aqueous lidocaine in IV rather than infiltrative application, can be of benefit to growing the knowledge of our field. However, we are concerned that the treatment described here sets a dangerous standard worthy of reproach.
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