Intravenous infusion of lidocaine for the prevention of chronic postoperative pain in children after various types of surgical interventions
DOI:
https://doi.org/10.15574/PS.2024.83.5Keywords:
surgical intervention, children, lidocaine, chronic postoperative painAbstract
Chronic postoperative pain is a serious postoperative complication. Inadequate pain management in the early postoperative period can contribute to the development of hyperalgesia.
Aim - to evaluate the effectiveness of intravenous infusion of lidocaine in the prevention of chronic postoperative pain after various types of surgical intervention in children and adolescents.
Materials and methods. 150 children who underwent under general multicomponent anesthesia surgical interventions due to traumatic pathology (I group, n=40), abdominal (II group, n=48) and urological (III group, n=62) surgical interventions were examined. Each of these groups was divided into two subgroups: in the subgroups Ib (n=17), IIb (n=19) and IIIb (n=24) children received intravenous lidocaine (according to the instructions) as a component of multimodal analgesia in the perioperative period, in the control subgroups Ia (n=23), IIa (n=29) and IIIa (n=38) children did not receive lidocaine. The presence of chronic postoperative pain 6 and 12 months after the operation, its frequency, localization, intensity according, the impact on the child’s daily activity were analyzed. Data analysis was performed using the statistical package «SPSS 20» (SPSS Inc.) version 21.0.0.
Results. Perioperative use of intravenous lidocaine infusion inpediatric patients was associated with a lower incidence of chronic pain 6 and 12 months after trauma surgery (odds ratio (OR): 5.13; 95% confidence interval (95% CI): 1.13-23.3 and OR: 4.24; 95% CI: 1.01-93.48, respectively) and after abdominal surgery (OR: 5.19; 95% CI: 1.02-26.94), as well as a higher level of functional activity after trauma (OR: 5.52; 95% CI: 1.08-28.2; p=0.028) and abdominal surgery (OR: 8.1; 95% CI: 1.01-70.36; p=0.032), but not after urological operations.
Conclusions. This study demonstrated the efficacy of intravenous infusion of lidocaine to prevent of chronic pain after trauma and abdominal surgery in pediatric patients.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Andreae MH, Andreae DA. (2013). Regional anaesthesia to prevent chronic pain after surgery: a cochrane systematic review and meta-analysis. Br J Anaesth. 111(5): 711-720. https://doi.org/10.1093/bja/aet213; PMid:23811426 PMCid:PMC3793661
Bailey M, Corcoran T, Schug S, Toner A. (2018). Perioperative lidocaine infusions for the prevention of chronic postsurgical pain: a systematic review and meta-analysis of efficacy and safety. Pain. 159(9): 1696-1704. https://doi.org/10.1097/j.pain.0000000000001273; PMid:29757886
Batoz H, Semjen F, Bordes-Demolis M, Bénard A, Nouette-Gaulain K. (2016). Chronic postsurgical pain in children: prevalence and risk factors. A prospective observational study, Br J Anaesth, 117(4): 489-496. https://doi.org/10.1093/bja/aew260; PMid:28077537
Beloeil H, Ababneh Z, Chung R, Zurakowski D, Mulkern RV, Berde CB. (2006). Effects of bupivacaine and tetrodotoxin on carrageenan- induced hind paw infl ammation in rats (part 1): hyperalgesia, edema, and systemic cytokines, Anesthesiology, 105(1), 128-138. https://doi.org/10.1097/00000542-200607000-00022; PMid:16810004
Beloeil H, Ji RR, Berde CB. (2006). Effects of bupivacaine and tetrodotoxin on carrageenan-induced hind paw infl ammation in rats (part 2): cytokines and p38 mitogen- activated protein kinases in dorsal root ganglia and spinal cord. Anesthesiology. 105(1): 139-145. https://doi.org/10.1097/00000542-200607000-00023; PMid:16810005
Bennett M. (2001). The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs. Pain. 92(1-2): 147-157. https://doi.org/10.1016/S0304-3959(00)00482-6; PMid:11323136
Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J et al. (2005). Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 114(1-2): 29-36. https://doi.org/10.1016/j.pain.2004.12.010; PMid:15733628
Challapalli V, Tremont-Lukats IW, McNicol ED, Lau J, Carr DB. (2005). Systemic administration of local anesthetic agents to relieve neuropathic pain. The Cochrane database of systematic reviews. 4: CD003345. https://doi.org/10.1002/14651858.CD003345.pub2; PMCid:PMC6483498
Chan MT, Peyton PJ, Myles PS, Leslie K, Buckley N, Kasza J et al. (2016). Chronic postsurgical pain in the Evaluation of Nitrous Oxide in the Gas Mixture for Anaesthesia (ENIGMA)-II trial. Br J Anaesth. 117 6): 801-811. https://doi.org/10.1093/bja/aew338; PMid:27956679
Dahl JB, Kehlet H. (2011). Preventive analgesia. Curr Opin Anaesthesiol.24(3): 331-338. https://doi.org/10.1097/ACO.0b013e328345afd9; PMid:21478742
Gartner R, Jensen MB, Nielsen J, Ewertz M, Kroman N, Kehlet H. (2009). Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA. 302(18): 1985-1992. https://doi.org/10.1001/jama.2009.1568; PMid:19903919
Gomon ML, Goncharuk OS, Tytarenko NV, Voznyuk AV, Kostiuchenko AV. (2022). Efficacy and safety of prolonged intravenous infusion of lidocaine for postoperative analgesia and recovery after surgical procedures in children aged 8-17 years. Paediatric surgery (Ukraine). 3(76): 19-26. https://doi.org/10.15574/PS.2022.76.19
Gomon ML, Goncharuk OS, Tytarenko NV, Voznyuk AV, Kostiuchenko AV. (2022). Dynamics of stress-response markers and the functional state of the autonomic nervous system as an indicator of sufficient anesthetic support using intravenous infusion of lidocaine in children. Paediatric surgery (Ukraine). 4(77): 9-16. https://doi.org/10.15574/PS.2022.77.9
Grigoras A, Lee P, Sattar F, Shorten G. (2012). Perioperative intravenous lidocaine decreases the incidence of persistent pain after breast surgery. The Clinical journal of pain. 28(7), 567-572. https://doi.org/10.1097/AJP.0b013e31823b9cc8; PMid:22699129
Heath C, Hii J, Thalayasingam P, von Ungern-Sternberg BS, Sommerfield D. (2023). Perioperative intravenous lidocaine use in children. Paediatr Anaesth. 33(5): 336-346. https://doi.org/10.1111/pan.14608; PMid:36424875
Khan JS, Hodgson N, Choi S, Reid S, Paul JE, Hong NJL et al. (2019). Perioperative Pregabalin and Intraoperative Lidocaine Infusion to Reduce Persistent Neuropathic Pain After Breast Cancer Surgery: A Multicenter, Factorial, Randomized, Controlled Pilot Trial. J Pain. 20(8): 980-993. https://doi.org/10.1016/j.jpain.2019.02.010; PMid:30844507
Koppert W, Ostermeier N, Sittl R, Weidner C, Schmelz M. (2000). Low-dose lidocaine reduces secondary hyperalgesia by a central mode of action. Pain. 85(1-2): 217-224. https://doi.org/10.1016/S0304-3959(99)00268-7; PMid:10692621
Koppert W, Zeck S, Sittl R, Likar R, Knoll R, Schmelz M. (1998). Low-dose lidocaine suppresses experimentally induced hyperalgesia in humans. Anesthesiology. 89(6): 1345-1353. https://doi.org/10.1097/00000542-199812000-00011; PMid:9856708
Kranke P, Jokinen J, Pace NL, Schnabel A, Hollmann MW, Hahnenkamp K et al. (2015). Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. The Cochrane database of systematic reviews. 7: CD009642. https://doi.org/10.1002/14651858.CD009642.pub2
Kurt A, Seval M. (2021). The Effect of Finger Puppets on Postoperative Pain in Children: A Randomized Controlled Trial. Clinical and Experimental Health Sciences. 11(1): 113-118. https://doi.org/10.33808/clinexphealthsci.713672
Lauder GR. (2017). A Review of Intravenous Lidocaine Infusion Therapy for Paediatric Acute and Chronic Pain Management. In C Maldonado (Ed.), Pain relief. From analgesics to alternative therapies. InTech. Chapter 9. https://doi.org/10.5772/66771
Lee M, Silverman S, Hansen H, Patel V, Manchikanti L. (2011). A comprehensive review of opioid-induced hyperalgesia, Pain Physician. 14(2-3): 145-161. https://doi.org/10.36076/ppj.2011/14/145
Lu Y, Ding H, Shao C, Wang N, Shi J, Lian C et al. (2022). Effect of lidocaine perioperative infusion on chronic postsurgical pain in patients undergoing thoracoscopic radical pneumonectomy, BMC Anesthesiology. 22(1): 255. https://doi.org/10.1186/s12871-022-01795-2; PMid:35945486 PMCid:PMC9361613
Macrae WA. (2008). Chronic post-surgical pain: 10 years on. Br J Anaesth. 101(1): 77-86. https://doi.org/10.1093/bja/aen099; PMid:18434337
Marret E, Rolin M, Beaussier M, Bonnet F. (2008). Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br J Surg. 95(11): 1331-1338. https://doi.org/10.1002/bjs.6375; PMid:18844267
Martinez V, Baudic S, Fletcher D. (2013). Chronic postsurgical pain. Ann Fr Anesth Reanim. 32 (6): 422-435. https://doi.org/10.1016/j.annfar.2013.04.012; PMid:23747211
Mishchuk V. (2022). Assessment of Pain Syndrome in Children. Current State of the Problem. Emergency medicine. 8(79): 134-139. https://doi.org/10.22141/2224-0586.8.79.2016.90389
Rabbitts JA, Fisher E, Rosenbloom BN, Palermo TM. (2017). Prevalence and Predictors of Chronic Postsurgical Pain in Children: A Systematic Review and Meta-Analysis. Pain. 18(6): 605-614. https://doi.org/10.1016/j.jpain.2017.03.007; PMid:28363861 PMCid:PMC5457338
Rabbitts JA, Zhou C, Groenewald CB, Durkin L, Palermo TM. (2015). Trajectories of postsurgical pain in children: risk factors and impact of late pain recovery on long-term health outcomes after major surgery. Pain. 156(11): 2383-2389. https://doi.org/10.1097/j.pain.0000000000000281; PMid:26381701 PMCid:PMC4607609
Semkovych YaV. (2023). Management of chronic postsurgical pain and hyperalgesia in children and its influence on cognitive functioning. Neonatology, surgery and perinatal medicine. 3(49): 71-77. https://doi.org/10.24061/2413-4260.XIII.3.49.2023.10
Vadivelu N, Mitra S, Schermer E, Kodumudi V, Kaye AD, Urman RD. (2014). Preventive analgesia for postoperative pain control: a broader concept. Local Reg Anest. 7: 17-22. https://doi.org/10.2147/LRA.S62160; PMid:24872720 PMCid:PMC4012350
Van Der Wal SEI, Van Den Heuvel SAS, Radema SA, Van Berkum BFM, Vaneker M, Steegers MAH et al. (2016). The in vitro mechanisms and in vivo efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain. European journal of pain. 20(5): 655-674. https://doi.org/10.1002/ejp.794; PMid:26684648
Walker LS, Greene, JW. (1991). The functional disability inventory: measuring a neglected dimension of child health status. Journal of pediatric psychology. 16(1): 39-58. https://doi.org/10.1093/jpepsy/16.1.39; PMid:1826329
Werner MU, Kongsgaard UEI. (2014). Defining persistent post-surgical pain: is an update required? Br J Anaesth. 113(1): 1-4. https://doi.org/10.1093/bja/aeu012; PMid:24554546
Williams G, Howard RF, Liossi C. (2017). Persistent postsurgical pain in children and young people: prediction, prevention, and managemen. PAIN Reports. 2(5): e616. https://doi.org/10.1097/PR9.0000000000000616; PMid:29392231 PMCid:PMC5777679
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Paediatric Surgery (Ukraine)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “PAEDIATRIC SURGERY. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “PAEDIATRIC SURGERY.UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.