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Topical lidocaine patch 5% for acute postoperative pain control.
D Gilhooly1, B McGarvey, H O'Mahony
1Anaesthesia and Pain Management, Sligo General Hospital, Sligo, Ireland. d.gilhooly@excite.com
BMJ Case Reports
|June 21, 2012
Summary
This study explores using 5% lidocaine patches for pain relief after lower segment caesarean sections (LSCS) in patients with severe allergies. Lidocaine patches, combined with transcutaneous electrical nerve stimulation, effectively managed postoperative pain, offering a safe alternative analgesic option.
Area of Science:
- Anesthesiology
- Obstetrics
- Pain Management
Background:
- Postoperative pain management after lower segment caesarean section (LSCS) can be challenging, especially in patients with multiple drug allergies.
- Conventional analgesics may be contraindicated due to patient history of atopy and anaphylaxis.
Observation:
- A patient with a history of anaphylaxis to common analgesics and asthma triggered by aspirin underwent LSCS under spinal anesthesia.
- Postoperatively, the patient refused standard oral analgesics due to fear of allergic reactions.
Findings:
- Application of three 5% lidocaine patches to the LSCS wound provided significant pain relief, reducing visual analogue scale (VAS) scores from 10/10 to 5/10 at rest and 10/10 to 7/10 with movement.
- Adjunctive transcutaneous electrical nerve stimulation (TENS) further improved pain control, reducing VAS scores to 2/10, particularly for associated back pain.
Implications:
- Topical 5% lidocaine patches represent a novel, easy-to-apply, and minimally invasive option for managing postoperative LSCS pain.
- This method, when used as part of a multimodal analgesic strategy, offers a safe alternative for patients with contraindications to traditional pain medications.
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