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Consensus recommendations for paediatric airway topicalisation using lidocaine

Helen A Iliff1, Julia Parnell2, Paul A Baker3

  • 1Department of Anaesthesia, Cardiff and Vale University Health Board, Cardiff, UK.

Anaesthesia
|July 28, 2025
PubMed

Insights

This study provides crucial consensus recommendations for safe lidocaine dosing in pediatric airway topicalization. These guidelines aim to enhance patient safety by addressing dosing, recovery, and adverse events in children.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Patient Safety

Background:

  • Lidocaine is frequently used for airway topicalization in children.
  • Current evidence and guidelines for safe pediatric dosing are lacking.

Purpose of the Study:

  • To develop consensus recommendations for safe lidocaine use in pediatric airway topicalization.
  • To address the paucity of evidence regarding safe dosing practices.

Main Methods:

  • Systematic literature review followed by a three-round Delphi process.
  • Involved an international, multidisciplinary, multi-society expert working group.
  • Generated consensus recommendations across five key practice domains.

Main Results:

  • 21 recommendations were agreed upon in domains including dosing, recovery, adverse reactions, institutional responsibilities, and learning from events.
  • Evidence quality was limited (mainly grades C and D).
  • Recommendation strength was predominantly moderate (65-79% consensus) to strong (≥80% consensus).

Conclusions:

  • The developed consensus recommendations are intended to promote safe practices for airway topicalization with lidocaine in pediatric patients.
  • These guidelines aim to standardize and improve the safety of lidocaine administration in children.
Abstract

Keywords:
lidocainelignocainepaediatric airwaytopicalisation

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