It was with great interest that we read the report by Dryden et al
1regarding 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.
- 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.
Wilderness Environ Med. 2022; 33: 348-350
2Appropriate 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.
- 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.
Wilderness Environ Med. 2014; 25: S96-104
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- The use of intravenous lidocaine as an analgesic modality in the austere environment: two cases.Wilderness Environ Med. 2022; 33: 348-350
- Wilderness Medical Society practice guidelines for the treatment of acute pain in remote environments: 2014 update.Wilderness Environ Med. 2014; 25: S96-104
- The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety.Anaesthesia. 2021; 76: 238-250
- The Third American Society of Regional Anesthesia and Pain Medicine practice advisory on local anesthetic systemic toxicity: executive summary 2017.Reg Anesth Pain Med. 2018; 43: 113-123
- Intravenous lidocaine for acute pain: a systematic review.Pharmacotherapy. 2018; 38: 1250-1259
- Clinical presentation of local anesthetic systemic toxicity: a review of published cases, 1979 to 2009.Reg Anesth Pain Med. 2010; 35: 181-187
- Local anesthetic plasma concentrations as a valuable tool to confirm the diagnosis of local anesthetic systemic toxicity? A report of 10 years of experience.Pharmaceutics. 2022; 14: 708
Published online: February 21, 2023
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