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Pediatricians can
suggest the use of intraoperative and postoperative lidocaine IV as a part of
multimodal anesthesia in children who had spinal surgery.
As per the results of a
recent observational study issued in the Journal-Pain Medicine, intraoperative and
postoperative lidocaine intravenous (IV) usage as a part of multimodal
anesthesia may be helpful in decreasing the inflammatory-dependent
postoperative pain intensity.
The study authors assessed the effect of perioperative,
lidocaine IV infusion as a part of multimodal anesthesia on concentrations of particular
pain modulators.
A total of 44 children undergoing extensive
spinal surgery were split into 2 groups following the surgery i.e., study group
with 23 children, with lidocaine anesthetized as a co-analgesic, and the
control group with 22 children, anesthetized normally without lidocaine. The proinflammatory
mediators for example interleukin 6 (IL-6), neuron growth factor (NGF), high
mobility group box 1 (HMGB1), and FOS protein prior to, immediately after, 6
hours and 12 to 15 hours post- surgery. Pain intensity was assessed at
corresponding time points via a 10-point numerical/graphical scale.
As found, pain reduction was observed in resting state and during coughing until 6 hours post- surgery in children in lidocaine group than control group as shown in the following graph:
At 6 hours after surgery, lower NGF and IL-6 levels in
the lidocaine group versus controls were found. During the postoperative period in the study group, the mean
HMGB1 levels were comparatively stable, while significant increases at 6 hours
after surgery and slight decrease at 12–15 hours after surgery in the controls
were witnessed. A negative correlation between HMGB1, NGF, Il-6, and lidocaine
concentrations post-surgery was revealed. Also, no differences in FOS protein
levels between the groups were observed.
Pain Medicine
https://academic.oup.com/painmedicine/article-abstract/21/7/1464/5556332?redirectedFrom=fulltext
Intravenous, Perioperatively Administered Lidocaine Regulates Serum Pain Modulators’ Concentrations in Children Undergoing Spinal Surgery
Barbara Kościelniak-Merak et al.
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