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Preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: Results of a randomized, double blind, placebo controlled study
BACKGROUND: To evaluate whether pre‐emptive skin analgesia using a lidocaine patch 5% would improve the effects of systemic morphine analgesia for controlling acute post‐thoracotomy pain. METHODS: This was a double‐blind, placebo controlled, prospective study. Patients were randomly assigned to rece...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons Australia, Ltd
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449230/ https://www.ncbi.nlm.nih.gov/pubmed/30806017 http://dx.doi.org/10.1111/1759-7714.12975 |
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author | Fiorelli, Alfonso Pace, Caterina Cascone, Roberto Carlucci, Annalisa De Ruberto, Emanuele Izzo, Anna Cecilia Passavanti, Beatrice Chiodini, Paolo Pota, Vincenzo Aurilio, Caterina Santini, Mario Sansone, Pasquale |
author_facet | Fiorelli, Alfonso Pace, Caterina Cascone, Roberto Carlucci, Annalisa De Ruberto, Emanuele Izzo, Anna Cecilia Passavanti, Beatrice Chiodini, Paolo Pota, Vincenzo Aurilio, Caterina Santini, Mario Sansone, Pasquale |
author_sort | Fiorelli, Alfonso |
collection | PubMed |
description | BACKGROUND: To evaluate whether pre‐emptive skin analgesia using a lidocaine patch 5% would improve the effects of systemic morphine analgesia for controlling acute post‐thoracotomy pain. METHODS: This was a double‐blind, placebo controlled, prospective study. Patients were randomly assigned to receive lidocaine 5% patch (lidocaine group) or a placebo (placebo group) three days before thoracotomy. Postoperative analgesia was induced in all cases with intravenous morphine analgesia. The intergroup differences were assessed in order to evaluate whether the lidocaine patch 5% would have effects on pain intensity when at rest and after coughing (primary end‐point) on morphine consumption, on the recovery of respiratory function, and on peripheral painful pathways measured with N2 and P2 laser‐evoked potential (secondary end‐points). RESULTS: A total of 90 patients were randomized, of whom 45 were allocated to the lidocaine group and 45 to the placebo group. Lidocaine compared with the placebo group showed a significant reduction in pain intensity both at rest (P = 0.013) and after coughing (P = 0.015), and in total morphine consumption (P = 0.001); and also showed a better recovery of flow expiratory volume in one second (P = 0.025) and of forced vital capacity (P = 0.037). The placebo group compared with the lidocaine group presented a reduction in amplitude of N2 (P = 0.001) and P2 (P = 0.03), and an increase in the latency of N2 (P = 0.023) and P2 (P = 0.025) laser‐evoked potential. CONCLUSIONS: The preventive skin analgesia with lidocaine patch 5% seems to be a valid adjunct to intravenous morphine analgesia for controlling post‐thoracotomy pain. However, our initial results should be corroborated/confirmed by larger studies. |
format | Online Article Text |
id | pubmed-6449230 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley & Sons Australia, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-64492302019-04-15 Preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: Results of a randomized, double blind, placebo controlled study Fiorelli, Alfonso Pace, Caterina Cascone, Roberto Carlucci, Annalisa De Ruberto, Emanuele Izzo, Anna Cecilia Passavanti, Beatrice Chiodini, Paolo Pota, Vincenzo Aurilio, Caterina Santini, Mario Sansone, Pasquale Thorac Cancer Original Articles BACKGROUND: To evaluate whether pre‐emptive skin analgesia using a lidocaine patch 5% would improve the effects of systemic morphine analgesia for controlling acute post‐thoracotomy pain. METHODS: This was a double‐blind, placebo controlled, prospective study. Patients were randomly assigned to receive lidocaine 5% patch (lidocaine group) or a placebo (placebo group) three days before thoracotomy. Postoperative analgesia was induced in all cases with intravenous morphine analgesia. The intergroup differences were assessed in order to evaluate whether the lidocaine patch 5% would have effects on pain intensity when at rest and after coughing (primary end‐point) on morphine consumption, on the recovery of respiratory function, and on peripheral painful pathways measured with N2 and P2 laser‐evoked potential (secondary end‐points). RESULTS: A total of 90 patients were randomized, of whom 45 were allocated to the lidocaine group and 45 to the placebo group. Lidocaine compared with the placebo group showed a significant reduction in pain intensity both at rest (P = 0.013) and after coughing (P = 0.015), and in total morphine consumption (P = 0.001); and also showed a better recovery of flow expiratory volume in one second (P = 0.025) and of forced vital capacity (P = 0.037). The placebo group compared with the lidocaine group presented a reduction in amplitude of N2 (P = 0.001) and P2 (P = 0.03), and an increase in the latency of N2 (P = 0.023) and P2 (P = 0.025) laser‐evoked potential. CONCLUSIONS: The preventive skin analgesia with lidocaine patch 5% seems to be a valid adjunct to intravenous morphine analgesia for controlling post‐thoracotomy pain. However, our initial results should be corroborated/confirmed by larger studies. John Wiley & Sons Australia, Ltd 2019-02-25 2019-04 /pmc/articles/PMC6449230/ /pubmed/30806017 http://dx.doi.org/10.1111/1759-7714.12975 Text en © 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Fiorelli, Alfonso Pace, Caterina Cascone, Roberto Carlucci, Annalisa De Ruberto, Emanuele Izzo, Anna Cecilia Passavanti, Beatrice Chiodini, Paolo Pota, Vincenzo Aurilio, Caterina Santini, Mario Sansone, Pasquale Preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: Results of a randomized, double blind, placebo controlled study |
title | Preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: Results of a randomized, double blind, placebo controlled study |
title_full | Preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: Results of a randomized, double blind, placebo controlled study |
title_fullStr | Preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: Results of a randomized, double blind, placebo controlled study |
title_full_unstemmed | Preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: Results of a randomized, double blind, placebo controlled study |
title_short | Preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: Results of a randomized, double blind, placebo controlled study |
title_sort | preventive skin analgesia with lidocaine patch for management of post‐thoracotomy pain: results of a randomized, double blind, placebo controlled study |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449230/ https://www.ncbi.nlm.nih.gov/pubmed/30806017 http://dx.doi.org/10.1111/1759-7714.12975 |
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