Intravenous infusion of lidocaine for the prevention of chronic postoperative pain in children after various types of surgical interventions

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.