TY - JOUR
T1 - Molecular mechanisms of action of systemic lidocaine in acute and chronic pain: a narrative review
AU - Hermanns, Henning
AU - Hollmann, Markus W.
AU - Stevens, Markus F.
AU - Lirk, Philipp
AU - Brandenburger, Timo
AU - Piegeler, Tobias
AU - Werdehausen, Robert
N1 - Copyright © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.
PY - 2019/9
Y1 - 2019/9
N2 - Systemic administration of the local anaesthetic lidocaine is antinociceptive in both acute and chronic pain states, especially in acute postoperative and chronic neuropathic pain. These effects cannot be explained by its voltage-gated sodium channel blocking properties alone, but the responsible mechanisms are still elusive. This narrative review focuses on available experimental evidence of the molecular mechanisms by which systemic lidocaine exerts its clinically documented analgesic effects. These include effects on the peripheral nervous system and CNS, where lidocaine acts via silencing ectopic discharges, suppression of inflammatory processes, and modulation of inhibitory and excitatory neurotransmission. We highlight promising objectives for future research to further unravel these antinociceptive mechanisms, which subsequently may facilitate the development of new analgesic strategies and therapies for acute and chronic pain.
AB - Systemic administration of the local anaesthetic lidocaine is antinociceptive in both acute and chronic pain states, especially in acute postoperative and chronic neuropathic pain. These effects cannot be explained by its voltage-gated sodium channel blocking properties alone, but the responsible mechanisms are still elusive. This narrative review focuses on available experimental evidence of the molecular mechanisms by which systemic lidocaine exerts its clinically documented analgesic effects. These include effects on the peripheral nervous system and CNS, where lidocaine acts via silencing ectopic discharges, suppression of inflammatory processes, and modulation of inhibitory and excitatory neurotransmission. We highlight promising objectives for future research to further unravel these antinociceptive mechanisms, which subsequently may facilitate the development of new analgesic strategies and therapies for acute and chronic pain.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85068546551&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31303268
U2 - https://doi.org/10.1016/j.bja.2019.06.014
DO - https://doi.org/10.1016/j.bja.2019.06.014
M3 - Review article
C2 - 31303268
SN - 0007-0912
VL - 123
SP - 335
EP - 349
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 3
ER -