The effect of intravenous infusion of lidocaine on the course of the perioperative period in children under 7 years of age

Abstract

Annotation. At present, the treatment of perioperative pain syndrome in children remains unsolved. This issue is caused not only by a stereotypical approach to the assessment of pain intensity but also due to specific pharmacotherapy of pain in pediatric patients, especially those under the age of 7 years. The purpose of this study is to investigate the effect of intravenous infusion of lidocaine on the course of the perioperative period in children under the age of 7 years. We conducted a prospective controlled study that included 76 children (45 boys, 31 girls) who underwent surgical procedures under general anesthesia. Age of the patients was from 2 months to 7 years (3.72±2.26 years). Patients were divided into two groups: the first group (n=32) included children who received intravenous lidocaine during the perioperative period, and the second (control) group (n = 44) included children who were not prescribed lidocaine. Data analysis was performed using the statistical package "SPSS 20" (SPSS Inc.) version 21.0.0 for Windows. According to the obtained data, heart rate (HR) during operative procedures and a postoperative serum cortisol level were significantly lower in the lidocaine group compared to the control group (p<0.05). The pressor response to extubation in patients of the study group was less pronounced; namely HR -109.63±14.09 bpm. to 120.75±7.61 bpm. in the control group (p<0.001), the mean arterial pressure - 70.99±8.59 mm Hg to 75.59±7.24 mm Hg, respectively (p=0.017). During the 48-hour follow-up period after surgery, pain intensity according to the FLACC pain scale was significantly lower with lidocaine administration, similarly to the average doses of narcotic analgesics used perioperatively. Perspectives for further research include a subgroup analysis of the efficacy and safety of intravenous infusion of lidocaine over the course of the perioperative period in children, depending on the type and duration of surgical procedures.