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Systemic Lidocaine Infusion for Post-Operative Analgesia in Children Undergoing Laparoscopic Inguinal Hernia Repair:
Hye-Mi Lee1,2, Kwan-Woong Choi3, Hyo-Jin Byon1,2
1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
Insights
Intravenous lidocaine did not significantly reduce the need for rescue analgesia in children after laparoscopic inguinal hernia repair. However, it did lower the highest pain scores observed in the post-anesthesia recovery care unit.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Pharmacology
Background:
- Systemic lidocaine is effective for post-operative pain relief in adults.
- Pediatric post-operative pain management requires effective and safe analgesic strategies.
Purpose of the Study:
- To evaluate the efficacy of intravenous lidocaine for post-operative analgesia and recovery in children undergoing laparoscopic inguinal hernia repair.
Main Methods:
- A randomized controlled trial involving 66 children (6 months to <6 years) comparing lidocaine infusion to saline placebo.
- Pain assessment using the Face, Legs, Activity, Crying, and Consolability (FLACC) scale and Parents' Postoperative Pain Measure (PPPM).
Main Results:
- No significant difference in the number of patients requiring rescue analgesia in the post-anesthesia recovery care unit (PACU) (50% vs. 73%, p=0.063).
- A statistically significant lower highest FLACC score was observed in the lidocaine group compared to the control group in the PACU (3.8 vs. 5.3, p=0.029).
Conclusions:
- Systemic lidocaine did not reduce the overall need for rescue analgesia in the PACU for pediatric patients.
- Intravenous lidocaine may help in reducing peak pain intensity in the immediate post-operative period for children.
Abstract:
Systemic lidocaine can provide satisfactory post-operative analgesia in adults. In this study, we assessed whether intravenous lidocaine is effective for post-operative analgesia and recovery in children undergoing laparoscopic inguinal hernia repair. A total of 66 children aged from six months to less than six years were classified in either the lidocaine (L) or control (C) groups. Children in Group L received a lidocaine infusion (a bolus dose of 1 mL kg-1, followed by a 1.5 mg kg-1 h-1 infusion), whereas Group C received the same volume of 0.9% saline. The primary outcome was the number of patients who presented face, legs, activity, crying and consolability (FLACC) scores of four or more, and therefore received rescue analgesia in the post-anesthesia recovery care unit (PACU). Secondary outcomes included the highest FLACC score in the PACU, FLACC, and the parents' postoperative pain measure (PPPM) score at 48 h post-operation, as well as side effects. The number of children who received rescue analgesia in the PACU was 15 (50%) in Group L and 22 (73%) in Group C (p = 0.063). However, the highest FLACC score in PACU was lower in Group L (3.8 ± 2.4) than in Group C (5.3 ± 2.7) (p = 0.029). In conclusion, systemic lidocaine did not reduce the number of children who received rescue analgesia in PACU.
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