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Continuous Intravenous Lidocaine Provides Effective Pain Control in a Palliative Child: A Case Report
Carl Lo1, Sang Le, Marisa Bell
1From the Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California.
Insights
Lidocaine infusion effectively managed severe headaches in a child with a brain tumor, offering significant pain relief without common medication side effects. This approach provides a safer alternative for intractable pediatric pain.
Area of Science:
- Pediatric Neurology
- Pain Management
- Neuro-oncology
Background:
- Intractable headaches in children pose significant challenges.
- Brain tumors like ependymoma can cause severe pain and increased intracranial pressure.
- Conventional analgesics may have limiting side effects, including bleeding and sedation.
Abstract:
Lidocaine infusion is often used as part of a perioperative, multimodal pain management plan. We present its use to treat an 8-year-old child with devastating headaches. His symptoms stemmed from an inoperable supratentorial ependymoma that was causing thalamic bleeding and increased intracranial pressure. Many commonly used pain medications are associated with deleterious side effects such as bleeding and excessive sedation. These effects prevent lucidity for interactions, confound neurologic examination. A lidocaine infusion resulted in significant pain relief without these negative side effects. We discuss lidocaine infusion use and considerations for children suffering from intractable headaches.
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