Postoperative use and early discontinuation of intravenous lidocaine in spine patients.

Autor: Soriano PBO; Department of Orthopedic Surgery, University of Minnesota, 2512 South 7th Street, Suite R200, Minneapolis, MN, 55455, USA., Haselhuhn JJ; Department of Orthopedic Surgery, University of Minnesota, 2512 South 7th Street, Suite R200, Minneapolis, MN, 55455, USA. hasel080@umn.edu., Resch JC; Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA., Fischer GA; Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA., Swanson DB; Department of Orthopedic Surgery, University of Minnesota, 2512 South 7th Street, Suite R200, Minneapolis, MN, 55455, USA., Holton KJ; Department of Orthopedic Surgery, University of Minnesota, 2512 South 7th Street, Suite R200, Minneapolis, MN, 55455, USA., Polly DW Jr; Department of Orthopedic Surgery, University of Minnesota, 2512 South 7th Street, Suite R200, Minneapolis, MN, 55455, USA. pollydw@umn.edu.; Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA. pollydw@umn.edu.
Jazyk: angličtina
Zdroj: Spine deformity [Spine Deform] 2024 Jan; Vol. 12 (1), pp. 141-148. Date of Electronic Publication: 2023 Aug 23.
DOI: 10.1007/s43390-023-00753-3
Abstrakt: Purpose: Our institution employs a multimodal approach to manage postoperative pain after spine surgery. It involves continuous intravenous (IV) lidocaine until the morning of postoperative day two. This study aimed to determine the rate and reasons for early discontinuation of IV lidocaine in our spine patients.
Methods: We conducted a retrospective chart review and included pediatric patients who underwent ≥ 3-level spine surgery and received postoperative IV lidocaine from November 2019 to September 2022. For each case, we recorded the side effects of IV lidocaine, adverse events, time to discontinuation, and discontinuation rate. Subsequently, we used the same methodology to generate an adult cohort for comparison.
Results: We included 52 pediatric (18M:34F) and 50 (21M:29F) adult patients. The pediatric cohort's mean age was 14 years (8-18), and BMI 23.9 kg/m 2 (13.0-42.8). The adult cohort's mean age was 61 years (29-82), and BMI 28.8 kg/m 2 (17.2-44.1). IV lidocaine was discontinued prematurely in 21/52 (40.4%) of the pediatric cases and 26/50 (52.0%) of the adult cases (RR = 0.78, p = 0.2428). The side effects noted in the pediatric cases vary, including numbness, visual disturbance, and obtundation, but no seizures. The most common adverse events were fever and motor dysfunction.
Conclusion: The early discontinuation rate of IV lidocaine use after spine surgery for children in our institution does not differ significantly from that of adults. The nature of the side effects and the reasons for discontinuation between the groups were similar. Thus, the safety profile of IV lidocaine for pediatric spine patients is comparable to adults.
(© 2023. The Author(s), under exclusive licence to Scoliosis Research Society.)
Databáze: MEDLINE
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