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Safety and Tolerability of Intravenous Lidocaine Infusions as Opioid Adjunct for Children Hospitalized With Sickle

Ugochukwu Agbakwuru1, Jacob D AuBuchon2, Bobi Toebe2

  • 1Aflac Cancer and Blood Disorder Center, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA.

Pediatric Blood & Cancer
|December 12, 2024
PubMed

Insights

Intravenous lidocaine infusions as an adjunct to opioids for sickle cell disease (SCD) vaso-occlusive episodes (VOE) showed no serious toxicities in pediatric patients. Most recipients opted for repeat treatments, suggesting good tolerability.

Area of Science:

  • Pediatric Hematology
  • Pain Management
  • Pharmacology

Background:

  • Opioids are standard for sickle cell disease (SCD) vaso-occlusive episode (VOE) pain but carry side effects.
  • Non-opioid adjuvants may offer pain relief with improved safety profiles.
  • Intravenous lidocaine is explored as a potential adjunctive therapy.

Purpose of the Study:

  • To retrospectively investigate the safety and tolerability of intravenous lidocaine infusions.
  • To assess lidocaine's use as an adjunct to opioids in pediatric patients during VOE hospitalizations.

Main Methods:

  • Retrospective analysis of pediatric patients hospitalized for VOE.
  • Data collected over a 2-year period on lidocaine administration and patient outcomes.
  • Evaluation of toxicity, repeat treatment choices, and hospitalization duration.

Main Results:

  • Lidocaine was administered in 64.6% of 260 admissions.
  • No serious toxicities were reported.
  • 82.2% of recipients chose lidocaine for subsequent admissions, indicating good tolerability.
  • Lidocaine infusions were associated with longer hospitalizations, possibly due to selection bias.

Conclusions:

  • Intravenous lidocaine appears safe and well-tolerated as an adjunct to opioids for pediatric VOE.
  • Further prospective studies are needed to confirm the efficacy of adjuvant lidocaine infusions in VOE management.

Keywords:
opioidpain managementsickle cell diseasevaso‐occlusive pain

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