Chronic Pain, Lidocaine, Pain, Postoperative, Thoracic Surgery, Video-Assisted
Conditions
Keywords
postthoracotomy pain syndrome, chronic pain, lidocaine
Brief summary
This study seeks to investigate lidocaine infusion to reduce postthoractomy pain syndrome after thoracic Surgery
Detailed description
Postthoracotomy pain syndrome (PPS) is defined as a persistent and/or recurrent pain or burning sensation along the thoracotomy scar at 3 months after surgery. The pain is very significant, given that 3 to 5% of postthoractomy patients report it as being severe, and approximately 50% of patients report limitations in their activities of daily living. Little is known about the origin of this pain, but it seems that the intensity of acute postoperative pain is the best predictor of it. Lidocaine infusion could be a possible approach to reducing the prevalence of PPS. Recently, a meta-analysis concluded a modest but statistically significant reduction of pain severity in the first four postoperative hours measured by the visual analogue scale (mean difference, -0.84; 95% CI, -1.10 to -0.59). However, a more recent meta-analysis found that only limited clinical data and biological plausibility support lidocaine infusions for the prevention of postoperative persistent pain (odds ratio, 0.29; 95% CI, 0.18 to 0.48). This study was designed to investigate whether lidocaine infusion after video-assisted thoracoscopic surgery (VATS) would lower PPS at postoperative 3 and 6 month.
Interventions
DRUGLidocaine
Infusion of 2% lidocaine hydrochloride at 4 mL/h, started after tracheal intubation and discontinued until 24 h after surgery.
DRUGControl
Infusion of normal saline at 4 mL/h, started after tracheal intubation and discontinued until 24 h after surgery.
Sponsors
Guangzhou First People's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Patients scheduled to undergo a muscle-sparing lateral minithoracotomy for different thoracic diseases
Exclusion criteria
* (1)ASA classification status III or above * (2)Body weight\<35kg * (3)Liver cirrhosis * (4)A history of previous thoracotomy * (5)Pregnancy * (6)Severe arrhythmia * (7)Congestive heart failure * (8)Opioid or steroid use 6 months before surgery * (9)Allergy to lidocaine * (10)Chronic pain syndrome (any type) * (11)Emergency surgery * (12)Incapacity to give an informed consent, Visual dysfunction or severe mental disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Occurrence of chronic pain | At 3 months after surgery. | Chronic pain was assessed in accordance with the IMMPACT recommends in the domains of: (1) absence or presence of pain in the area of the surgery, (2) clinically important (NRS ≥ 4 on a 0- to 10-point scale) daily average pain, (3) clinically important pain at rest, (4) clinically important pain intensity upon movement or activity, (5) pain qualities, and (6) physical and emotional functioning. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative acute pain | postoperative days 1 and 2. | Use numeric rating scale (NRS) to assess the postoperative acute pain |
| Sedation | postoperative days 1 and 2. | Use numeric rating scale (NRS) to asses |
| Fatigue | postoperative days 1 and 2. | Use numeric rating scale (NRS) to assess |
| Occurrence of chronic pain at 6-month | At 6 months after surgery. | Chronic pain was assessed in accordance with the IMMPACT recommends in the domains of: (1) absence or presence of pain in the area of the surgery, (2) clinically important (NRS ≥ 4 on a 0- to 10-point scale) daily average pain, (3) clinically important pain at rest, (4) clinically important pain intensity upon movement or activity, (5) pain qualities, and (6) physical and emotional functioning. |
| Postoperative nausea and vomiting (PONV) nausea | postoperative days 1 and 2. | Use numeric rating scale (NRS) to assess |
Other
| Measure | Time frame | Description |
|---|---|---|
| Postthoracotomy ipsilateral shoulder pain | postoperative days 1 and 2. | Use numeric rating scale (NRS) to assess |
Countries
China
Contacts
Primary ContactXiangcai Ruan, PhD
Backup ContactDanyang Pan, MD
Outcome results
None listed