Intravenous lidocaine infusion in children

BACKGROUND: The problem of adequate analgesia in the early postoperative period is not relevant at present, both in our country and abroad because >50% of children experience pain after surgical interventions despite the ongoing therapy. Inadequate “ideal” method for assessing the pain syndrome severity, age restrictions with several drugs, and difficult communication with young children, as well as drug selection, lead to inadequate detection in pediatric practice.

AIM: This study aimed to evaluate the effectiveness and safety of intravenous infusion of lidocaine in the early postoperative period in children operated on the abdominal cavity organs.

MATERIALS AND METHODS: This study included 119 children who were randomized into 3 groups, in which intravenous lidocaine infusion, prolonged epidural blockade, or systemic fentanyl analgesia were used for pain relief after abdominal surgery. Hemodynamic parameters, respiratory system, pain intensity, resolution time of intestinal paresis, cortisol, glucose and lidocaine levels in blood plasma, and complications were monitored and compared intergroup.

RESULTS: Lidocaine infusion had no effects on the hemodynamics and respiratory system in children. Cortisol level was markedly decreased through the day to baseline (320±65 nmol/l). Early recovery of peristalsis corresponded to 23±3.75 h postoperatively. The pain syndrome intensity during the observation period did not exceed 2 points. The maximum level of free lidocaine in blood plasma was 2.81±1.31 µg/ml, and the time spent in the intensive care unit (ICU) was 48±10 h.

CONCLUSION: Intravenous infusion of lidocaine after abdominal surgery in children is a safe method that provides effective pain relief, restores peristalsis early, and reduces the length of ICU stay.