Aerosolized lidocaine does not confer benefit as an add-on therapy to reduce respiratory therapy-associated pain after pediatric congenital heart surgery: a randomized, double-blind, placebo-controlled trial

• Ano de defesa: 2021
• Autor(a) principal: Silva, Thalis Henrique da
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: eng
• Instituição de defesa: Biblioteca Digitais de Teses e Dissertações da USP
• Palavras-chave em Português: Anesthetic drugs; Cardiopatia congênita; Cirurgia cardíaca; Congenital heart disease; Dor pós operatória; Droga anestésica; Fisioterapia respiratória; Openheart surgery; Postoperative pain; Respiratory therapy
• Link de acesso: https://www.teses.usp.br/teses/disponiveis/17/17144/tde-08092021-164508/

Objective: To investigate whether respiratory therapy (RT) increases pain if inhaled lidocaine can attenuate pain increase in infants and children undergoing surgery for congenital heart disease (CHD). Design: Double-blind, randomized, placebo-controlled trial. Setting: Pediatric intensive care unit in a Brazilian tertiary-care, university hospital. Patients: 119 patients < 18 years submitted to open-heart surgery for CHD. Interventions: Aerosolized lidocaine (1 mg/kg) before RT maneuvers and tracheal suction, compared to placebo. Measurements and main results: Pain was assessed by the face, legs, activity, cry, consolability pain scale - revised (FLACC-R), along with hemodynamic and ventilatory parameters, before and after RT and tracheal suction on postoperative days 1, 3, and 7. Lidocaine or placebo were administered right before RT. RT induced minor changes in pain, which were not attenuated by lidocaine (confirmed in multivariate analysis). RT also induced minor, not clinically relevant effects in hemodynamic and ventilatory parameters, which were also not modified by lidocaine. Conclusions: Respiratory therapy did not increase postoperative pain in patients after pediatric congenital heart surgery up to the 7th day, nor aerosolized lidocaine exhibited any clinically significant effect on pain or other hemodynamic or ventilatory parameters.