Questions · Perioperative Intravenous Lidocaine
9 questions, 0 approved. Approve them one at a time — a quiz shows nothing you have not.
Recall — derived from a kept point
For intravenous lidocaine given at commonly recommended perioperative doses, describe its therapeutic index and where plasma concentrations sit relative to cardiotoxic and neurotoxic thresholds, and state what that comparison is used for.
Answer: At commonly recommended doses lidocaine's therapeutic index is very high and plasma concentrations stay well below cardiotoxic and neurotoxic thresholds, which is the basis for judging its benefit-risk against other analgesic strategies.
The safety case for perioperative lidocaine is a margin argument: at recommended doses plasma levels sit well below the cardiotoxic and neurotoxic thresholds, which is what lets you weigh it against other analgesic strategies.
Source claim: At commonly recommended doses lidocaine's therapeutic index is very high and plasma concentrations stay well below cardiotoxic and neurotoxic thresholds, which is the basis for judging its benefit-risk against other analgesic strategies.
Perioperative Use of Intravenous Lidocaine, Drugs 2018
recall · CA-1 · phrased by llm
In the ALLEGRO trial, 2% intravenous lidocaine was studied after minimally invasive colon resection. State the primary outcome, the result including both group rates, and what happened to the trial's secondary outcomes.
Answer: The primary outcome was return of gut function at 72 hours, and lidocaine did not improve it: 57.3% versus 59.0%. None of the eleven secondary outcomes differed either.
ALLEGRO is a clean negative trial: no improvement in 72-hour gut function and no difference in any of eleven secondary outcomes.
Source claim: In the ALLEGRO trial, 2% intravenous lidocaine did not improve return of gut function at 72 hours after minimally invasive colon resection (57.3% versus 59.0%) and none of eleven secondary outcomes differed.
Intravenous Lidocaine for Gut Function Recovery in Colonic Surgery, JAMA 2025
recall · CA-2 · phrased by llm
A systematic review of randomised trials of intravenous lidocaine infusion found benefit in some operations and not others. Name the surgical settings where benefit was seen, quantify the effect on first flatus and on length of stay, and name the three operations in which no effect was found.
Answer: In abdominal and ambulatory surgery lidocaine infusion reduced pain and opioid use, brought first flatus up to 23 hours earlier and shortened stay by about 1.1 days, but it had no effect in tonsillectomy, hip arthroplasty or coronary bypass.
Lidocaine is not a general-purpose analgesic: in this review the benefit sat in abdominal and ambulatory surgery and vanished in tonsillectomy, hip arthroplasty and coronary bypass.
Source claim: In abdominal and ambulatory surgery, lidocaine infusion reduced pain and opioid use, brought first flatus up to 23 hours earlier and shortened stay by about 1.1 days, but had no effect in tonsillectomy, hip arthroplasty or coronary bypass.
Impact of Intravenous Lidocaine Infusion on Postoperative Analgesia and Recovery From Surgery: A Systematic Review of Randomized Controlled Trials, Drugs 2010
recall · CA-2 · phrased by llm
A Cochrane review of 68 trials and 4,525 patients assessed continuous perioperative intravenous lidocaine infusion for early postoperative pain. State the quality of evidence it assigned, describe how much the infusion regimens varied, and explain what that combination prevents you from specifying at the bedside.
Answer: The Cochrane review found the evidence for lidocaine on early postoperative pain very low quality, with infusion regimens varying from 1 to 5 mg/kg/h and no consistent stopping point. Very low quality evidence plus that spread of regimens means the review cannot specify an infusion rate or a stopping point to use.
Sixty-eight trials and 4,525 patients still left this at very low quality evidence, with rates from 1 to 5 mg/kg/h and no consistent stopping point, so whatever regimen you run is not one the evidence pins down.
Source claim: The Cochrane review of 68 trials and 4,525 patients found the evidence for lidocaine on early postoperative pain very low quality, with infusion regimens varying from 1 to 5 mg/kg/h and no consistent stopping point.
Continuous Intravenous Perioperative Lidocaine Infusion for Postoperative Pain and Recovery in Adults, The Cochrane database of systematic reviews 2018
recall · CA-3 · phrased by llm
Perioperative lidocaine in breast cancer surgery reduced persistent pain at three months from ___% to 11.8% and reduced the area of secondary hyperalgesia.
Answer: 47.4
Perioperative lidocaine in breast cancer surgery reduced persistent pain at three months from 47.4% to 11.8% and reduced the area of secondary hyperalgesia.
Perioperative Intravenous Lidocaine Decreases the Incidence of Persistent Pain After Breast Surgery · PMID 22699129
recall · CA-2 · phrased by derived
The point with one number taken out. No model wrote any of this: the stem is the sentence you reviewed, minus a digit, and the paper it came from is named beneath it.
Open prompts
How does your plan change if the patient is not optimised?
open · CA-2 · phrased by derived
What is the physiology behind what we just did?
open · CA-2 · phrased by derived
Talk me through the trade-off you made there.
open · CA-2 · phrased by derived
What would make you abandon this plan and do something else?
open · CA-2 · phrased by derived
Questions only — nothing here asserts anything, which is why a model is allowed to phrase them. Where no model was reachable these are the level defaults.