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Lidocaine Infusion for Postthoracotomy Pain Syndrome

Not Applicable
Conditions
Chronic Pain
Thoracic Surgery, Video-Assisted
Lidocaine
Pain, Postoperative
Interventions
Drug: Control
Registration Number
NCT03666299
Lead Sponsor
Guangzhou First People's Hospital
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.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
72
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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ControlControlPlacebo treatment
LidocaineLidocaineLidocaine treatment
Primary Outcome Measures
NameTimeMethod
Occurrence of chronic painAt 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 Outcome Measures
NameTimeMethod
Postoperative acute painpostoperative days 1 and 2.

Use numeric rating scale (NRS) to assess the postoperative acute pain

Sedationpostoperative days 1 and 2.

Use numeric rating scale (NRS) to asses

Postoperative nausea and vomiting (PONV) nauseapostoperative days 1 and 2.

Use numeric rating scale (NRS) to assess

Fatiguepostoperative days 1 and 2.

Use numeric rating scale (NRS) to assess

Occurrence of chronic pain at 6-monthAt 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.

Trial Locations

Locations (1)

Guangzhou First People's Hospital

🇨🇳

Guangzhou, Guangdong, China

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