Perioperative intravenous lidocaine use in children

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Pain Management

Background:

• Effective perioperative pain management is crucial for pediatric patients, impacting recovery and family well-being.
• Opioid-sparing analgesia is sought due to adverse effects and limitations of other adjuncts like ketamine and alpha agonists.
• Intravenous lidocaine presents an emerging alternative with demonstrated anti-neuropathic, anti-hyperalgesic, and anti-inflammatory properties.

Purpose of the Study:

• To evaluate the efficacy and safety of perioperative intravenous lidocaine in pediatric surgical patients.
• To explore its potential benefits in reducing opioid consumption and improving postoperative outcomes.
• To address the need for more pediatric-specific data on intravenous lidocaine's use.

Main Methods:

• Review of existing literature on perioperative intravenous lidocaine use in pediatric populations.
• Analysis of reported outcomes including analgesia, opioid use, gastrointestinal function, mobilization, and length of stay.
• Assessment of safety data and adverse event profiles associated with studied dose ranges.

Main Results:

• Adult studies show benefits like reduced opioid use, improved GI function, and shorter hospital stays.
• Limited pediatric data suggests similar benefits, with some findings replicated in children.
• Current pediatric studies indicate intravenous lidocaine is well-tolerated within studied dose ranges, with no serious side effects reported.

Conclusions:

• Perioperative intravenous lidocaine appears to be a beneficial adjunct for pain management in select pediatric surgical patients.
• Further large-scale trials are necessary to establish definitive pediatric pharmacokinetics and comprehensive safety data.
• Intravenous lidocaine offers a promising opioid-sparing strategy for improving pediatric perioperative care.