Intravenous lidocaine infusion reduces intrathecal opioid-induced pruritus after cesarean delivery: a randomized controlled trial and proof-of-concept
Authors' conclusion
Intravenous lidocaine infusion reduced the incidence and early severity of neuraxial morphine-induced pruritus after cesarean delivery without increased adverse events.
Study context
- Population
- Women undergoing elective cesarean delivery under spinal anaesthesia with intrathecal morphine 150 μg136 analysed
- Participants
- 160 women
- Comparison
- IV lidocaine vs saline placebo
- Lidocainen = 69
- Controln = 67reference
- Primary endpoint
- Incidence of pruritus
- Follow-up
- 24 h
Methodological detailsdouble-blind, placebo-controlled, single-centre
- Double-blind
- Placebo-controlled
- Single-centre
Primary result
As reported in the abstract
Absolute risk reduction
36.9%
95% CI 21.4–52.4
Lidocaine
NNT
3
95% CI 2–5
Lidocaine
Secondary outcomes
Rescue nalbuphine use
absolute risk reduction 33.5% (18.0–49.0)
| Outcome | NNT (95% CI) |
|---|---|
| Rescue nalbuphine use | 3 (2–6) |
Pruritus severity
- Lower in the lidocaine group during the first 12 h postoperatively; differences not significant at 16 and 24 h
Safety
- No symptoms of lidocaine toxicity or increased adverse events observed
Original publication
Intravenous lidocaine infusion reduces intrathecal opioid-induced pruritus after cesarean delivery: a randomized controlled trial and proof-of-concept. Int J Obstet Anesth. Published 2 December 2025. doi:10.
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