IV Lidocaine Analgesia in Pediatric Scoliosis Surgery

• Status: Recruiting
• Trial end date: 2022-12-01
• Target enrollment: 0
• Participant gender: All

Summary

Surgical correction of scoliosis in children is a long procedure, with an equivalently long recovery time, that is commonly performed at BC Children's Hospital. Treating pain immediately after the procedure is a priority for children during recovery. Morphine is one medication that can be used to manage post-operative pain, but unfortunately, its use is accompanied by a number of side effects which can affect recovery. These include nausea, vomiting, pruritus, sedation, dysphoria, respiratory depression, constipation, ileus, and urinary retention.

In order to control pain and reduce morphine consumption, intravenous lidocaine is being investigated. This therapy has been beneficial in adult populations undergoing abdominal surgery and has been associated with decreased post-operative pain, decrease use of opioids including morphine, and ileus. These all contribute to shorter lengths of stay in the hospital and better recovery in the adult population.

Intravenous lidocaine is used by some anesthesiologists at BC Children's Hospital to manage post-operative pain in children receiving surgical correction for scoliosis, but this is not a standard of practice. We now propose to conduct a double-blind randomized controlled trial to determine if intravenous lidocaine, infused from start of anesthesia up to 48 hours post-operatively, will reduce morphine use and improve post-operative pain in the pediatric population.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of British Columbia
• Treatments: Lidocaine

Criteria

Inclusion Criteria:

• ASA I-III

• Diagnosed with Idiopathic scoliosis

• Undergoing single-stage posterior spinal instrumentation and fusion

Exclusion Criteria:

• Thorascopic tethering procedure

• Two-stage procedure

• Abnormal developmental profile

• Congenital/neuromuscular scoliosis

• Requiring PICU admission

• Known allergy to lidocaine

• Known cardiac, renal or liver disease or dysfunction

• Pre-existing pain complaints, i.e. on regular analgesic medications

• Current psychiatric diagnosis, e.g. anxiety, depression, eating disorder, defined according to DSM criteria.

• Requiring non-standard post-op pain management

• Any history of seizures

• Unplanned staged procedure

• Weight < 5th centile or > 85th centile for age

• Porphyria