Protocol of intravenous lidocaine infusion in the postoperative period in children operated on abdominal organs

BACKGROUND: Many studies indicate the effectiveness of intravenous lidocaine infusion for perioperative analgesia and treatment of intestinal paresis in adults. In the scientific literature, only a few publications focus on the intravenous infusion of lidocaine in pediatric practice.

The purpose of the work is to increase the effectiveness of the treatment of pain syndrome after operations on abdominal organs in children by creating a protocol for intravenous lidocaine infusion.

MATERIALS AND METHODS: In the development of the clinical protocol, publications included in the databases PubMed, Cochrane, American Society of Anesthesiologists, World Federation of Pediatric Intensive and Critical Care Societies, and American Academy of Pediatrics were considered. The recommendations and standards of care for this problem from the Committee on Pediatric Anesthesiology (“Statement on Practice Recommendations for Pediatric Anesthesia,” 2016), Society for Paediatric Anesthesia Anaesthesiology, and our own materials for our research performed at the St. Petersburg State Pediatric Medical University.

RESULTS: The developed protocol includes 11 provisions, including indications and contraindications to the use of lidocaine infusion, preoperative examination, a list of necessary equipment, the method of infusion, methods of evaluation, and control of postoperative pain syndrome.

CONCLUSIONS: A protocol for the management of children in the early postoperative period using intravenous lidocaine infusion, as an alternative to prolonged epidural blockade and systemic anesthesia, is developed. The authors express confidence that further implementation of the protocol in clinical practice will improve the quality of medical care for children after abdominal surgical interventions.