{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:54:04Z","timestamp":1777312444844,"version":"3.51.4"},"reference-count":60,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"\n Background:<\/jats:bold>\n Intravenous lidocaine is used to treat acute postoperative pain by reducing discomfort, accelerating mobilization, and shortening hospitalization. This study evaluated the effects of intravenous bolus and continuous lidocaine infusion on pain intensity, fentanyl requirements, and plasma norepinephrine levels in hysterectomy surgery under spinal anesthesia.\n <\/jats:p>\n \n Methods:<\/jats:bold>\n A double-blinded randomized clinical trial was conducted on 46 patients undergoing hysterectomy with spinal anesthesia. The lidocaine group (\n n<\/jats:italic>\n = 23) received a 2% lidocaine bolus (1.5 mg\/kg) followed by a continuous infusion (1 mg\/kg\/hour) for 24 hours. The control group (\n n<\/jats:italic>\n = 23) received 0.9% NaCl. Resting and moving numeric rating scale (NRS) pain scores, total fentanyl requirements, and norepinephrine levels were recorded at 4, 6, 12, and 24 hours postoperatively.\n <\/jats:p>\n \n Results:<\/jats:bold>\n Statistically significant differences in resting pain NRS were observed at the 4th, 6th, 12th, and 24th hours (0.52 \u00b1 0.51 vs. 1.52 \u00b1 0.51, 0.61 \u00b1 0.58 vs. 1.52 \u00b1 0.51, 0.52 \u00b1 0.51 vs. 1.74 \u00b1 0.81, and 0.52 \u00b1 0.51 vs. 1.52 \u00b1 0.51, respectively;\n p<\/jats:italic>\n < 0.001). The reduction in pain score on the moving NRS in the lidocaine group was significantly greater at 6 hours (2.22 \u00b1 0.79 vs. 2.91 \u00b1 1.04;\n p<\/jats:italic>\n = 0.001) and 12 hours (2.26 \u00b1 0.75 vs. 2.57 \u00b1 1.12;\n p<\/jats:italic>\n < 0.001) postoperatively compared to the control group. Total fentanyl requirements were significantly lower in the lidocaine group (103.04 \u00b1 33.63 mcg vs. 421.74 \u00b1 74.32 mcg;\n p<\/jats:italic>\n < 0.001). Plasma norepinephrine changes differed significantly at T6\u2013T0 (\u22120.66 \u00b1 1.81 pg\/mL vs. 1.98 \u00b1 1.69 pg\/mL;\n p<\/jats:italic>\n < 0.001) and T24\u2013T0 (\u22121.74 \u00b1 1.94 pg\/mL vs. 1.53 \u00b1 1.12 pg\/mL;\n p<\/jats:italic>\n < 0.001). No side effects were observed.\n <\/jats:p>\n \n Conclusion:<\/jats:bold>\n Intravenous bolus and continuous lidocaine infusion reduced postoperative pain intensity, fentanyl requirements, and norepinephrine levels without significant side effects.\n <\/jats:p>","DOI":"10.5339\/qmj.2025.81","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T05:30:40Z","timestamp":1757568640000},"source":"Crossref","is-referenced-by-count":0,"title":["Intravenous lidocaine reduces pain intensity and attenuates the increase in plasma norepinephrine levels after hysterectomy"],"prefix":"10.5339","volume":"2025","author":[{"given":"Andi Muhammad Takdir","family":"Musba","sequence":"first","affiliation":[{"name":"Universitas Hasanuddin Fakultas Kedokteran, Makassar, Indonesia*Address for Correspondence: Andi Muhammad Takdir Musba takdir1974@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srimulyanto","family":"Sardi","sequence":"additional","affiliation":[{"name":"Universitas Hasanuddin Fakultas Kedokteran, Makassar, Indonesia*Address for Correspondence: Andi Muhammad Takdir Musba takdir1974@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Ratnawati","sequence":"additional","affiliation":[{"name":"Universitas Hasanuddin Fakultas Kedokteran, Makassar, Indonesia*Address for Correspondence: Andi Muhammad Takdir Musba takdir1974@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"issue":"(2):","key":"CIT0001","series-title":"Pain Rep","first-page":"e588","article-title":"Postoperative pain-from mechanisms to treatment","volume":"2","author":"Pogatzki-Zahn\n \nEM","year":"2017"},{"issue":"(2):","key":"CIT0002","series-title":"J Anestesi Perioperatif","first-page":"145\u201352","article-title":"Comparison between the effect of single dose 150 mg and 300 mg pregabalin of Numeric Rating Scale value and post operative analgesia requirement in abdominal hysterectomy patients","volume":"2","author":"Elvidiansyah, Fuadi\n \nI","year":"2014"},{"issue":"(2):","key":"CIT0003","series-title":"Ann Surg","first-page":"192\u2013200","article-title":"Systemic lidocaine shortens length of hospital stay after colorectal surgery: a double-blinded, randomized, placebo-controlled trial","volume":"246","author":"Herroeder\n \nS","year":"2007"},{"issue":"(3):","key":"CIT0004","series-title":"Can J Surg","first-page":"175\u201382","article-title":"Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal gastrectomy: a prospective, randomized, double-blind, placebo-controlled study","volume":"57","author":"Yon\n \nJH","year":"2014"},{"issue":"(2):","key":"CIT0005","series-title":"Anesth Analg","first-page":"235\u20139","article-title":"Intravenous lidocaine speeds the return of bowel function, decreases postoperative pain, and shortens hospital stay in patients undergoing radical retropubic prostatectomy","volume":"86","author":"Groudine\n \nSB","year":"1998"},{"issue":"(1):","key":"CIT0006","series-title":"J Clin Transl Sci","first-page":"e114","article-title":"Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain","volume":"5","author":"Uribe-Rivera\n \nA","year":"2021"},{"key":"CIT0007","series-title":"Brain Res Bull","first-page":"21\u20136","article-title":"Correlation between the increased release of catecholamines evoked by local anesthetics and their analgesic and adverse effects: Role of K(+) channel inhibition","volume":"(124):","author":"Sircuta\n \nC","year":"2016"},{"issue":"(4):","key":"CIT0008","series-title":"Pain","first-page":"759\u201364","article-title":"Effects of acute postoperative pain on catecholamine plasma levels, hemodynamic parameters, and cardiac autonomic control","volume":"153","author":"Ledowski\n \nT","year":"2012"},{"issue":"(4):","key":"CIT0009","series-title":"Am J Obstet Gynecol","first-page":"611.e1\u2013e12","article-title":"Trends and predictors of hysterectomy prevalence among women in the United States","volume":"227","author":"Harvey\n \nSV","year":"2022"},{"issue":"(10):","key":"CIT0010","series-title":"Cancer Causes Control","first-page":"829\u201335","article-title":"Variation in hysterectomy prevalence and trends among U.S. States and Territories-Behavioral Risk Factor Surveillance System, 2012\u20132020","volume":"34","author":"Gopalani\n \nSV","year":"2023"},{"issue":"(06):","key":"CIT0011","series-title":"EAS J Med Surg","first-page":"199\u2013207","article-title":"Adequacy of postoperative pain management among patients undergoing laparotomy at Bugando Medical Centre. Mwanza, Tanzania","volume":"6","author":"Munisi\n \nI","year":"2024"},{"issue":"(2):","key":"CIT0012","series-title":"Indian J Anaesth","first-page":"111\u20135","article-title":"American Society of Anaesthesiologists physical status classification","volume":"55","author":"Daabiss\n \nM","year":"2011"},{"key":"CIT0013","series-title":"J Pain Res","first-page":"2287\u201398","article-title":"Poorly controlled postoperative pain: prevalence, consequences, and prevention","volume":"(10):","author":"Gan\n \nTJ","year":"2017"},{"key":"CIT0014","series-title":"Anesthesiology","first-page":"p. 703\u201321","article-title":"Pharmacology of opioid analgesic","author":"Rosow\n \nC","year":"2012"},{"issue":"(1):","key":"CIT0015","series-title":"Anesthesiology","first-page":"11\u20138","article-title":"Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy","volume":"106","author":"Kaba\n \nA","year":"2007"},{"issue":"(4):","key":"CIT0016","series-title":"Nepal Med Coll J","first-page":"215\u201320","article-title":"Perioperative intravenous lidocaine infusion on postoperative pain relief in patients undergoing upper abdominal surgery","volume":"12","author":"Baral\n \nBK","year":"2010"},{"key":"CIT0017","series-title":"Opioid analgesics","author":"Cohen\n \nB","year":"2023"},{"issue":"(3):","key":"CIT0018","series-title":"Can J Surg","first-page":"175\u201382","article-title":"Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal gastrectomy: a prospective, randomized, double-blind, placebo-controlled study","volume":"57","author":"Yon\n \nJH","year":"2014"},{"issue":"(3):","key":"CIT0019","series-title":"Int J Reprod Contracept Obstet Gynecol","first-page":"1095\u2013105","article-title":"Preemptive use of adjunctive IV lidocaine for enhanced recovery after abdominal hysterectomy for overweight and obese women: a prospective, randomized, double-blind, placebo-controlled study","volume":"10","author":"Shady\n \nNW","year":"2021"},{"issue":"(1):","key":"CIT0020","series-title":"Int J Surg","first-page":"1265\u201374","article-title":"Perioperative intravenous lidocaine infusion improves postoperative analgesia after hysterectomy: a systematic review and meta-analysis of randomized controlled trials","volume":"111","author":"Tang\n \nP","year":"2025"},{"issue":"(8):","key":"CIT0021","series-title":"Can J Anaesth","first-page":"759\u201366","article-title":"Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy","volume":"57","author":"Bryson\n \nGL","year":"2010"},{"issue":"(3):","key":"CIT0022","series-title":"J Anestesi Perioperatif","first-page":"167\u201373","article-title":"The effect of intravenous lidocaine on Numeric Rating Scale value and postoperative fentanyl requirement in general anesthesia","volume":"1","author":"Sipahutar\n \nTC","year":"2013"},{"issue":"(4):","key":"CIT0023","series-title":"Anesthesiology","first-page":"932\u201340","article-title":"Effect of perioperative intravenous lidocaine administration on pain, opioid consumption, and quality of life after complex spine surgery","volume":"119","author":"Farag\n \nE","year":"2013"},{"issue":"(1):","key":"CIT0024","series-title":"Ann Surg","first-page":"99\u2013104","article-title":"Health care spending and new persistent opioid use after surgery","volume":"272","author":"Lee\n \nJS","year":"2020"},{"key":"CIT0025","series-title":"Front Public Health","first-page":"1157484","article-title":"Cost-effectiveness of the perioperative pain management bundle a registry-based study","volume":"11","author":"Bojic\n \nS","year":"2023"},{"issue":"(1):","key":"CIT0026","series-title":"Signal Transduct Target Ther","first-page":"155\u201363","article-title":"Pathology of pain and its implications for therapeutic interventions","volume":"9","author":"Cao\n \nB","year":"2024"},{"issue":"(10):","key":"CIT0027","series-title":"Anesth Analg","first-page":"1008\u201313","article-title":"Effects of lidocaine infusion on the sympathetic response to abdominal surgery","volume":"66","author":"Wallin\n \nG","year":"1987"},{"issue":"(2):","key":"CIT0028","series-title":"Clin Exp Emerg Med","first-page":"121\u20136","article-title":"Local anesthetic systemic toxicity: awareness, recognition, and risk mitigation in the emergency department","volume":"11","author":"Shalaby\n \nM","year":"2024"},{"issue":"(2):","key":"CIT0029","series-title":"J Hand Surg Glob Online","first-page":"196\u2013200","article-title":"Safety of lidocaine during wide-awake local anesthesia no tourniquet for distal radius plating","volume":"5","author":"Abdullah\n \nS","year":"2023"},{"issue":"(2):","key":"CIT0030","series-title":"Anaesthesia","first-page":"238\u201350","article-title":"The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety","volume":"76","author":"Foo\n \nI","year":"2021"},{"issue":"(2):","key":"CIT0001","series-title":"Pain Rep","first-page":"e588","article-title":"Postoperative pain-from mechanisms to treatment","volume":"2","author":"Pogatzki-Zahn\n \nEM","year":"2017"},{"issue":"(2):","key":"CIT0002","series-title":"J Anestesi Perioperatif","first-page":"145\u201352","article-title":"Comparison between the effect of single dose 150 mg and 300 mg pregabalin of Numeric Rating Scale value and post operative analgesia requirement in abdominal hysterectomy patients","volume":"2","author":"Elvidiansyah, Fuadi\n \nI","year":"2014"},{"issue":"(2):","key":"CIT0003","series-title":"Ann Surg","first-page":"192\u2013200","article-title":"Systemic lidocaine shortens length of hospital stay after colorectal surgery: a double-blinded, randomized, placebo-controlled trial","volume":"246","author":"Herroeder\n \nS","year":"2007"},{"issue":"(3):","key":"CIT0004","series-title":"Can J Surg","first-page":"175\u201382","article-title":"Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal gastrectomy: a prospective, randomized, double-blind, placebo-controlled study","volume":"57","author":"Yon\n \nJH","year":"2014"},{"issue":"(2):","key":"CIT0005","series-title":"Anesth Analg","first-page":"235\u20139","article-title":"Intravenous lidocaine speeds the return of bowel function, decreases postoperative pain, and shortens hospital stay in patients undergoing radical retropubic prostatectomy","volume":"86","author":"Groudine\n \nSB","year":"1998"},{"issue":"(1):","key":"CIT0006","series-title":"J Clin Transl Sci","first-page":"e114","article-title":"Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain","volume":"5","author":"Uribe-Rivera\n \nA","year":"2021"},{"key":"CIT0007","series-title":"Brain Res Bull","first-page":"21\u20136","article-title":"Correlation between the increased release of catecholamines evoked by local anesthetics and their analgesic and adverse effects: Role of K(+) channel inhibition","volume":"(124):","author":"Sircuta\n \nC","year":"2016"},{"issue":"(4):","key":"CIT0008","series-title":"Pain","first-page":"759\u201364","article-title":"Effects of acute postoperative pain on catecholamine plasma levels, hemodynamic parameters, and cardiac autonomic control","volume":"153","author":"Ledowski\n \nT","year":"2012"},{"issue":"(4):","key":"CIT0009","series-title":"Am J Obstet Gynecol","first-page":"611.e1\u2013e12","article-title":"Trends and predictors of hysterectomy prevalence among women in the United States","volume":"227","author":"Harvey\n \nSV","year":"2022"},{"issue":"(10):","key":"CIT0010","series-title":"Cancer Causes Control","first-page":"829\u201335","article-title":"Variation in hysterectomy prevalence and trends among U.S. States and Territories-Behavioral Risk Factor Surveillance System, 2012\u20132020","volume":"34","author":"Gopalani\n \nSV","year":"2023"},{"issue":"(06):","key":"CIT0011","series-title":"EAS J Med Surg","first-page":"199\u2013207","article-title":"Adequacy of postoperative pain management among patients undergoing laparotomy at Bugando Medical Centre. Mwanza, Tanzania","volume":"6","author":"Munisi\n \nI","year":"2024"},{"issue":"(2):","key":"CIT0012","series-title":"Indian J Anaesth","first-page":"111\u20135","article-title":"American Society of Anaesthesiologists physical status classification","volume":"55","author":"Daabiss\n \nM","year":"2011"},{"key":"CIT0013","series-title":"J Pain Res","first-page":"2287\u201398","article-title":"Poorly controlled postoperative pain: prevalence, consequences, and prevention","volume":"(10):","author":"Gan\n \nTJ","year":"2017"},{"key":"CIT0014","series-title":"Anesthesiology","first-page":"p. 703\u201321","article-title":"Pharmacology of opioid analgesic","author":"Rosow\n \nC","year":"2012"},{"issue":"(1):","key":"CIT0015","series-title":"Anesthesiology","first-page":"11\u20138","article-title":"Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy","volume":"106","author":"Kaba\n \nA","year":"2007"},{"issue":"(4):","key":"CIT0016","series-title":"Nepal Med Coll J","first-page":"215\u201320","article-title":"Perioperative intravenous lidocaine infusion on postoperative pain relief in patients undergoing upper abdominal surgery","volume":"12","author":"Baral\n \nBK","year":"2010"},{"key":"CIT0017","series-title":"Opioid analgesics","author":"Cohen\n \nB","year":"2023"},{"issue":"(3):","key":"CIT0018","series-title":"Can J Surg","first-page":"175\u201382","article-title":"Intraoperative systemic lidocaine for pre-emptive analgesics in subtotal gastrectomy: a prospective, randomized, double-blind, placebo-controlled study","volume":"57","author":"Yon\n \nJH","year":"2014"},{"issue":"(3):","key":"CIT0019","series-title":"Int J Reprod Contracept Obstet Gynecol","first-page":"1095\u2013105","article-title":"Preemptive use of adjunctive IV lidocaine for enhanced recovery after abdominal hysterectomy for overweight and obese women: a prospective, randomized, double-blind, placebo-controlled study","volume":"10","author":"Shady\n \nNW","year":"2021"},{"issue":"(1):","key":"CIT0020","series-title":"Int J Surg","first-page":"1265\u201374","article-title":"Perioperative intravenous lidocaine infusion improves postoperative analgesia after hysterectomy: a systematic review and meta-analysis of randomized controlled trials","volume":"111","author":"Tang\n \nP","year":"2025"},{"issue":"(8):","key":"CIT0021","series-title":"Can J Anaesth","first-page":"759\u201366","article-title":"Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy","volume":"57","author":"Bryson\n \nGL","year":"2010"},{"issue":"(3):","key":"CIT0022","series-title":"J Anestesi Perioperatif","first-page":"167\u201373","article-title":"The effect of intravenous lidocaine on Numeric Rating Scale value and postoperative fentanyl requirement in general anesthesia","volume":"1","author":"Sipahutar\n \nTC","year":"2013"},{"issue":"(4):","key":"CIT0023","series-title":"Anesthesiology","first-page":"932\u201340","article-title":"Effect of perioperative intravenous lidocaine administration on pain, opioid consumption, and quality of life after complex spine surgery","volume":"119","author":"Farag\n \nE","year":"2013"},{"issue":"(1):","key":"CIT0024","series-title":"Ann Surg","first-page":"99\u2013104","article-title":"Health care spending and new persistent opioid use after surgery","volume":"272","author":"Lee\n \nJS","year":"2020"},{"key":"CIT0025","series-title":"Front Public Health","first-page":"1157484","article-title":"Cost-effectiveness of the perioperative pain management bundle a registry-based study","volume":"11","author":"Bojic\n \nS","year":"2023"},{"issue":"(1):","key":"CIT0026","series-title":"Signal Transduct Target Ther","first-page":"155\u201363","article-title":"Pathology of pain and its implications for therapeutic interventions","volume":"9","author":"Cao\n \nB","year":"2024"},{"issue":"(10):","key":"CIT0027","series-title":"Anesth Analg","first-page":"1008\u201313","article-title":"Effects of lidocaine infusion on the sympathetic response to abdominal surgery","volume":"66","author":"Wallin\n \nG","year":"1987"},{"issue":"(2):","key":"CIT0028","series-title":"Clin Exp Emerg Med","first-page":"121\u20136","article-title":"Local anesthetic systemic toxicity: awareness, recognition, and risk mitigation in the emergency department","volume":"11","author":"Shalaby\n \nM","year":"2024"},{"issue":"(2):","key":"CIT0029","series-title":"J Hand Surg Glob Online","first-page":"196\u2013200","article-title":"Safety of lidocaine during wide-awake local anesthesia no tourniquet for distal radius plating","volume":"5","author":"Abdullah\n \nS","year":"2023"},{"issue":"(2):","key":"CIT0030","series-title":"Anaesthesia","first-page":"238\u201350","article-title":"The use of intravenous lidocaine for postoperative pain and recovery: international 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