Effectiveness of intravenous infusion of lidocaine for postoperative analgesia in children after various types of surgical interventions
DOI:
https://doi.org/10.15574/SP.2024.139.71Keywords:
surgical intervention, children, lidocaine, postoperative analgesiaAbstract
Numerous studies have demonstrated the effectiveness of intravenous infusion of lidocaine for postoperative analgesia in abdominal surgery among adult patients. However, this approach is rarely used among pediatric patients.
Aim - to conduct a comparative evaluation of various methods of postoperative analgesia and their effects on the dynamics of pain intensity indicators and the cumulative daily dose of morphine in pediatric patients after various types of surgical interventions.
Materials and methods. We examined 150 children who underwent trauma (I group, n=40), abdominal (II group, n=48), and urological (III group, n=62) surgical interventions. Each group was divided into two subgroups. Children received intravenous lidocaine as a component of multimodal analgesia in the perioperative period in subgroups Ib (n=17), IIb (n=19), and IIIb (n=24). Children were not prescribed lidocaine in control groups Ia (n=23), IIa (n=29), and IIIa (n=38). To assess the intensity of postoperative pain, a numerical rating scale (NRS) was used. Statistical processing of the obtained data was carried out using the SPSS 21 statistical information processing package (©SPSS Inc.).
Results. The results of our study show that the intensity of pain was significantly lower in the early period of observation (from 3 to 9 hours) and the intermediate period (24 hours) of the postoperative period, but not in the late period of observation (48 hours and more). The impact of systemic administration of lidocaine on the reduction of pain at rest after trauma surgical interventions has not been determined. Postoperative systemic use of lidocaine in children reduced the average cumulative daily dose of morphine during the 1st day after all types of surgical interventions.
Conclusions. This study demonstrated the efficacy of intravenous infusion of lidocaine in the treatment of postoperative pain syndrome in pediatric patients.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Batko I, Kościelniak-Merak B, Tomasik PJ, Kobylarz K, Wordliczek J. (2020). Lidocaine as an element of multimodal analgesic therapy in major spine surgical procedures in children: a prospective, randomized, double-blind study. Pharmacological Reports. 72 (3): 744-755. https://doi.org/10.1007/s43440-020-00100-7; PMid:32297162 PMCid:PMC7329801
Challapalli V, Tremont-Lukats IW, McNicol ED, Lau J, Carr DB. (2005). Systemic administration of local anesthetic agents to relieve neuropathic pain. The Cochrane database of systematic reviews. 4, CD003345. https://doi.org/10.1002/14651858.CD003345.pub2; PMCid:PMC6483498
Cooke C, Kennedy ED, Foo I, Nimmo S, Speake D, Paterson HM, Ventham NT. (2019). Meta-analysis of the effect of perioperative intravenous lidocaine on return of gastrointestinal function after colorectal surgery. Techniques in Coloproctology. 23 (1): 15-24. https://doi.org/10.1007/s10151-019-1927-1; PMid:30721376 PMCid:PMC6394718
Fung AC, Chu FY, Chan IH, Wong KK. (2023). Enhanced recovery after surgery in pediatric urology: Current evidence and future practice. Journal of pediatric urology. 19 (1): 98-106. https://doi.org/10.1016/j.jpurol.2022.07.024; PMid:35995660
Gebremedhn EG, Sefefe WM. (2022). Pre-emptive Analgesia for the Prevention of Chronic Postsurgical Pain: A Systematic Review and Meta-analysis with Trial Sequential Analysis. J Anesth Clin Res. 13 (11): 1-11.
Gilbert CR, Hanson IR, Brown AB, Hingson RA. (1951). Intravenous use of xylocaine. Current Researches in Anesthesia and Analgesi. 30 (6): 301-313. https://doi.org/10.1213/00000539-195101000-00057
Gomon ML, Goncharuk OS, Tytarenko NV, Voznyuk AV, Kostiuchenko AV. (2022). Efficacy and safety of prolonged intravenous infusion of lidocaine for postoperative analgesia and recovery after surgical procedures in children aged 8-17 years. Paediatric surgery. Ukraine. 3 (76): 19-26. https://doi.org/10.15574/PS.2022.76.19
Gomon ML, Goncharuk OS, Tytarenko NV, Voznyuk AV, Kostiuchenko AV. (2022). Dynamics of stress-response markers and the functional state of the autonomic nervous system as an indicator of sufficient anesthetic support using intravenous infusion of lidocaine in children. Paediatric surgery. Ukraine. 4 (77): 9-16. https://doi.org/10.15574/PS.2022.77.9
Kościelniak-Merak B, Batko I, Kobylarz K, Sztefko K, Tomasik PJ. (2020). Intravenous, perioperatively administered lidocaine regulates serum pain modulators' concentrations in children undergoing spinal surgery. Pain Medicine. 21 (7): 1464-1473. https://doi.org/10.1093/pm/pnz212; PMid:31504866
Kranke P, Jokinen J, Pace NL, Schnabel A, Hollmann MW, Hahnenkamp K, et al. (2015). Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. The Cochrane database of systematic reviews. 7, CD009642. https://doi.org/10.1002/14651858.CD009642.pub2
Lemming K, Fang G, Buck ML. (2019). Safety and tolerability of lidocaine infusions as a component of multimodal postoperative analgesia in children. The Journal of Pediatric Pharmacology and Therapeutics. 24 (1): 34-38. https://doi.org/10.5863/1551-6776-24.1.34; PMid:30837812 PMCid:PMC6397014
Mishchuk V. (2022). Assessment of Pain Syndrome in Children. Current State of the Problem. Emergency medicine. 8 (79): 134-139. https://doi.org/10.22141/2224-0586.8.79.2016.90389
Nakajima D, Kawakami H, Mihara T, Sato H, Goto T. (2020). Effectiveness of intravenous lidocaine in preventing postoperative nausea and vomiting in pediatric patients: A systematic review and meta-analysis. PLoS One. 15 (1): e0227904. https://doi.org/10.1371/journal.pone.0227904; PMid:31990953 PMCid:PMC6986726
Soto G, González MN, Calero F. (2018). Intravenous lidocaine infusion. Revista Española de Anestesiología y Reanimación (English Edition). 65 (5): 269-274. https://doi.org/10.1016/j.redar.2018.01.004; PMid:29496229
Van Der Wal SEI, Van Den Heuvel SAS, Radema SA, Van Berkum BFM, Vaneker M, Steegers MAH, et al. (2016). The in vitro mechanisms and in vivo efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain. European journal of pain. 20 (5): 655-674. https://doi.org/10.1002/ejp.794; PMid:26684648
Vigneault L, Turgeon AF, Côté D, Lauzier F, Zarychanski R, Moore L, et al. (2011). Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials. Can J Anaesth. 5 (1): 22-37. https://doi.org/10.1007/s12630-010-9407-0; PMid:21061107
Weibel S, Jokinen J, Pace NL, Schnabel A, Hollmann MW, Hahnenkamp K, et al. (2016). Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis. British journal of anaesthesia. 116 (6): 770-783. https://doi.org/10.1093/bja/aew101; PMid:27199310
Weibel S, Rücker G, Eberhart LH, Pace NL, Hartl HM, Jordan OL, et al. (2020). Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis. The Cochrane database of systematic reviews. 2020; 10 (10): CD012859. https://doi.org/10.1002/14651858.CD012859.pub2; PMid:33075160 PMCid:PMC8094506
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