Continuous Lidocaine Infusion for Management of Perioperative Burn Pain
| Status: | Completed |
|---|---|
| Conditions: | Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 7/5/2018 |
| Start Date: | September 2012 |
| End Date: | February 2015 |
Thermal injury results in one of the most intense and prolonged forms of pain the body can
experience. Opioid narcotics are the most powerful drugs for acute and chronic pain, and
their use in the perioperative period has been the mainstay of treatment; although medication
requirements in burn patients are often underestimated. More medication may not be the
answer, as relatively large doses of short acting opioids in the operative theater are
associated with greater postoperative opioid consumption and higher pain scores. Furthermore,
extensive use of opioids has resulted in the development of by hyperalgesia and allodynia.
Lidocaine is an amide local anesthetic that has analgesic, anti-hyperalgesic, antiarrhythmic,
and anti-inflammatory properties. Over the past 25 years, systemic lidocaine has been used
for perioperative pain management in a variety of surgical procedures. The design of this
study will examine if lidocaine will reduce the pain scores and narcotic utilization in
patients undergoing surgical procedures for burn injuries. The intervention group will
receive a bolus dose of lidocaine followed by a continuous infusion over 24 hours. The
control group will get an equal volume of saline. The investigators will compare pain scores,
opioid use, and narcotic equivalents based on body weight and burn surface area (BSA)
grafted.
experience. Opioid narcotics are the most powerful drugs for acute and chronic pain, and
their use in the perioperative period has been the mainstay of treatment; although medication
requirements in burn patients are often underestimated. More medication may not be the
answer, as relatively large doses of short acting opioids in the operative theater are
associated with greater postoperative opioid consumption and higher pain scores. Furthermore,
extensive use of opioids has resulted in the development of by hyperalgesia and allodynia.
Lidocaine is an amide local anesthetic that has analgesic, anti-hyperalgesic, antiarrhythmic,
and anti-inflammatory properties. Over the past 25 years, systemic lidocaine has been used
for perioperative pain management in a variety of surgical procedures. The design of this
study will examine if lidocaine will reduce the pain scores and narcotic utilization in
patients undergoing surgical procedures for burn injuries. The intervention group will
receive a bolus dose of lidocaine followed by a continuous infusion over 24 hours. The
control group will get an equal volume of saline. The investigators will compare pain scores,
opioid use, and narcotic equivalents based on body weight and burn surface area (BSA)
grafted.
Inclusion Criteria:
- Burn patient ≥ 18 years of age
- Burn patient scheduled to go to OR for excision and/or grafting procedure
Exclusion Criteria:
- Burn patient < 18 years of age
- Intubated patient on sedation drip
- Prolonged hypotension defined as Systolic Blood Pressure (SBP) < 90 mm/Hg for greater
than 30 minutes in the pre-op area
- Severe underlying cardiovascular disease (documented ejection fraction < 40%)
- Documented conduction block, bradycardia or active congestive heart failure
- Documented active gastritis or ulcers
- Previous steroid medication history if documented adrenal insufficiency
- Patient with documented liver disease
- Patient with epilepsy or known seizure disorder
- Pregnant Women
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Regions Hospital Established in 1872, Regions Hospital is a private, not-for-profit organization. The hospital provides...
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