Related Experiment Videos
Intravenous, Perioperatively Administered Lidocaine Regulates Serum Pain Modulators' Concentrations in Children
Barbara Kościelniak-Merak1, Ilona Batko2, Krzysztof Kobylarz2,3
1Department of Clinical Biochemistry, Pediatrics Institute, Jagiellonian University Medical College, Cracow, Poland.
Insights
Perioperative intravenous lidocaine infusion reduced pain intensity and inflammatory markers in children undergoing spinal surgery. This suggests lidocaine can be an effective component of multimodal anesthesia for managing postoperative pain.
Area of Science:
- Anesthesiology and Pain Management
- Pediatric Surgery
- Inflammation and Immunology
Background:
- Multimodal anesthesia aims to optimize pain control and reduce opioid use.
- Perioperative intravenous lidocaine has shown analgesic properties.
- Understanding lidocaine's effect on specific pain modulators is crucial for its clinical application.
Purpose of the Study:
- To analyze the influence of perioperative intravenous lidocaine infusion on pain modulator concentrations in children undergoing spinal surgery.
- To evaluate the impact of lidocaine as part of multimodal anesthesia on postoperative pain intensity.
Main Methods:
- Observational study involving 44 children undergoing extensive spinal surgery.
- Two groups: study group (n=23) received intravenous lidocaine as a co-analgesic, control group (n=22) did not.
- Assessed proinflammatory mediators (NGF, HMGB1, IL-6, FOS) and pain intensity at multiple time points.
Main Results:
- Lidocaine group showed reduced pain intensity at rest and during movement up to six hours post-surgery.
- Lower NGF and IL-6 concentrations were observed in the lidocaine group at six hours.
- HMGB1 concentrations were more stable in the lidocaine group compared to significant increases in controls.
- A negative correlation was found between lidocaine concentrations and inflammatory markers (HMGB1, NGF, IL-6).
Conclusions:
- Intraoperative and postoperative intravenous lidocaine administration may reduce inflammatory-dependent postoperative pain.
- Lidocaine can be a valuable adjunct in multimodal anesthesia for pediatric spinal surgery.
- Further research can explore optimal dosing and long-term effects.
Objectives:
We analyzed the influence of perioperative, intravenous (i.v.) lidocaine infusion as a part of multimodal anesthesia on concentrations of selected pain modulators.
Design:
An observational study.
Setting:
University Children's Hospital in Cracow, Poland, from May 2015 to May 2018.
Subjects:
Forty-four children undergoing extensive spinal surgery, divided into two groups after surgery: the study group (N = 23), anesthetized generally with lidocaine as a co-analgesic, and the control group (N = 22), anesthetized generally without lidocaine.
Methods:
We assessed proinflammatory mediators like neuron growth factor (NGF), high mobility group box 1 (HMGB1), interleukin 6 (IL-6), and FOS protein before, immediately after, six hours and 12-15 hours after surgery. We evaluated pain intensity at corresponding time points using a 10-point numerical/graphical scale.
Results:
We observed that children in the lidocaine group had reduced pain intensity in the resting state and during movement until six hours after surgery when compared with controls. We found lower NGF concentrations in the lidocaine group vs controls only at six hours after surgery. Mean HMGB1 concentrations during the postoperative period in the study group were relatively stable, whereas we observed significant increases at six hours after surgery and a slight decrease at 12-15 hours after surgery in the control group. IL-6 concentrations at six hours were lower in lidocaine patients when compared with controls. We noted a negative correlation between HMGB1, NGF, Il-6, and lidocaine concentrations after surgery. We did not find any differences in FOS protein concentrations between the groups.
Conclusions:
Our findings suggest that intraoperative and postoperative i.v. lidocaine administration as a part of multimodal anesthesia may reduce inflammatory-dependent postoperative pain intensity.