Abstract
Systemic lidocaine can provide satisfactory post-operative analgesia in adults. In this study, we assessed whether intravenous lidocaine is effective for post-operative analgesia and recovery in children undergoing laparoscopic inguinal hernia repair. A total of 66 children aged from six months to less than six years were classified in either the lidocaine (L) or control (C) groups. Children in Group L received a lidocaine infusion (a bolus dose of 1 mL kg−1, followed by a 1.5 mg kg−1 h−1 infusion), whereas Group C received the same volume of 0.9% saline. The primary outcome was the number of patients who presented face, legs, activity, crying and consolability (FLACC) scores of four or more, and therefore received rescue analgesia in the post-anesthesia recovery care unit (PACU). Secondary outcomes included the highest FLACC score in the PACU, FLACC, and the parents’ postoperative pain measure (PPPM) score at 48 h post-operation, as well as side effects. The number of children who received rescue analgesia in the PACU was 15 (50%) in Group L and 22 (73%) in Group C (p = 0.063). However, the highest FLACC score in PACU was lower in Group L (3.8 ± 2.4) than in Group C (5.3 ± 2.7) (p = 0.029). In conclusion, systemic lidocaine did not reduce the number of children who received rescue analgesia in PACU.
Highlights
Systemic lidocaine can provide satisfactory analgesia with less opioid use and enhance the overall quality of recovery, after open or laparoscopic abdominal surgery in adults [1,2]
Our findings demonstrate that intravenous lidocaine infusion reduced the severity of the pain measured by the FLACC score in children undergoing laparoscopic hernia repair, the number of patients with FLACC scores of four or higher who received rescue analgesia was not significantly reduced
The other published study indicated that lidocaine (1.5 mg kg−1 over five minutes followed by 2 mg kg−1 h−1) decreased postoperative vomiting in children undergoing an elective tonsillectomy [13]
Summary
Systemic lidocaine can provide satisfactory analgesia with less opioid use and enhance the overall quality of recovery, after open or laparoscopic abdominal surgery in adults [1,2]. Despite such advantages, systemic lidocaine has not been studied thoroughly in the pediatric population. Laparoscopic approaches in pediatric surgery have increased significantly [3], but some studies indicate that laparoscopic hernia repair is not superior to open surgery in terms of the severity of post-operative pain [4,5]. Regional analgesia affects somatic pain, it is unlikely to fully alleviate the response from visceral stimulation [8]. Convincing systemic analgesic methods need to be further studied
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