Lidocaine infusion in hip arthroplasty: Modulation of the surgical immune response and postoperative pain
Quentin J Baca, MD, PhD1, Leslie McNeil, Robin Okada, RN, Martha Tingle, RN, Nima Aghaeepour1, PhD, Brice Gaudilliere1, MD, PhD, and Martin S Angst, MD
Lidocaine is increasingly used as a perioperative analgesic and also possesses poorly understood “anti-inflammatory” properties. While the direct analgesic mechanisms of lidocaine have been studied, the indirect effects of lidocaine on the immune system and its modulation of the inflammatory stress response are not understood despite being critical to recovery after surgery. This IRB-approved study (IRB-34915) used mass cytometry (CyTOF) analysis of the peripheral immune system of hip arthroplasty patients who were treated with intravenous lidocaine to provide a unique understanding of the immunomodulatory mechanisms of lidocaine and its systemic effects that may alter pain trajectories after major surgery. Here, we present first evidence demonstrating clinical reduction in pain after hip arthroplasty and molecular evidence of the anti-inflammatory effects of lidocaine.