{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:59:27Z","timestamp":1790067567927,"version":"4.0.1"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Opioids are commonly used for postoperative analgesia, but concerns about their potential link to cancer progression and metastasis have led to interest in opioid-free regimens. Intravenous lignocaine, with its analgesic and potential anticancer properties, is emerging as an alternative. We aimed to compare the incidence of inadequate postoperative analgesia and the need for rescue medications between intravenous lignocaine and morphine following major head and neck surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective observational study included 40 adult patients who had undergone major head and neck surgeries with reconstruction, divided into two groups. Group M received morphine 0.02 mg\/kg\/h infusion, and Group L received lignocaine 0.5 mg\/kg\/h infusion for postoperative analgesia. Data on hemodynamic responses, rescue analgesic use, and ventilation duration were extracted from electronic medical records and intensive care unit nurses\u2019 charts. Inadequate analgesia was defined as a &gt;20% increase in heart rate or mean arterial pressure (MAP) from baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Group L showed a significantly lower incidence of inadequate analgesia (20%) compared to Group M (20% vs. 80%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0002). Patients in Group L required significantly less rescue clonidine (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and had significantly lower total dexmedetomidine consumption and duration of infusion. Mean heart rate and MAP were significantly higher in Group M at various postoperative time points. Postoperative ventilation duration was comparable between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Intravenous lignocaine significantly reduced inadequate analgesia and need for rescue medications with optimal hemodynamics in the immediate postoperative period following major head and neck surgeries. Further large-scale, prospective, randomized controlled trials are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_437_25","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:00:52Z","timestamp":1789531252000},"page":"1711-1715","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Analgesic Efficacy of Extended Opioid-free Anesthesia Regimen with Intravenous Lignocaine versus Morphine Following Major Head and Neck Surgeries"],"prefix":"10.4103","volume":"25","author":[{"given":"Sunil","family":"Rajan","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gayathri","family":"Sreekumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maharnab","family":"Bhuyan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fazil","family":"Haleel","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maneesh Sheela","family":"Manikandan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"R1-20260922","doi-asserted-by":"crossref","first-page":"5499","DOI":"10.3390\/cancers13215499","article-title":"Opioids and breast cancer recurrence: A systematic review","volume":"13","author":"Lucia","year":"2021","journal-title":"Cancers (Basel)"},{"key":"R2-20260922","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1097\/ALN.0000000000001528","article-title":"Lidocaine induces apoptosis and suppresses tumor growth in human hepatocellular carcinoma cells in vitro and in a xenograft model in vivo","volume":"126","author":"Xing","year":"2017","journal-title":"Anesthesiology"},{"key":"R3-20260922","doi-asserted-by":"crossref","first-page":"e12364","DOI":"10.1111\/cpr.12364","article-title":"Lidocaine inhibits the proliferation of lung cancer by regulating the expression of GOLT1A","volume":"50","author":"Zhang","year":"2017","journal-title":"Cell Prolif"},{"key":"R4-20260922","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/bjaed\/mkw008","article-title":"Intravenous lidocaine for acute pain: An evidence-based clinical update","volume":"16","author":"Eipe","year":"2016","journal-title":"BJA Educ"},{"key":"R5-20260922","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s40122-022-00459-w","article-title":"Postoperative pain in patients undergoing cancer surgery and intravenous patient-controlled analgesia use: The first and second 24 h experiences","volume":"12","author":"Chen","year":"2023","journal-title":"Pain Ther"},{"key":"R6-20260922","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.bj.2022.07.008","article-title":"Lidocaine reinforces the anti-inflammatory action of dexamethasone on myeloid and epithelial cells activated by inflammatory cytokines or SARS-CoV-2 infection","volume":"46","author":"Elizagaray","year":"2023","journal-title":"Biomed J"},{"key":"R7-20260922","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1051\/mbcb\/2023001","article-title":"The impact of lidocaine gel on TNF-a expression in surgically induced oral mucosal ulcers: An immunohistochemical analysis in rabbits","volume":"29","author":"Hamed","year":"2023","journal-title":"J Oral Med Oral Surg"},{"key":"R8-20260922","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1113\/jphysiol.2007.136671","article-title":"Setting up for the block: The mechanism underlying lidocaine's use-dependent inhibition of sodium channels","volume":"582","author":"Cummins","year":"2007","journal-title":"J Physiol"},{"key":"R9-20260922","doi-asserted-by":"crossref","first-page":"802592. 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