Godoy-Salinas E, De RD, Rodríguez-Piñón E, Figueroa-García J

Language: Spanish
References: 18
Page: 220-225
PDF size: 207.97 Kb.

ABSTRACT

Introduction: knee arthroscopy is a common orthopedic procedure associated with postoperative pain, so optimizing pain management is essential for patient recovery and satisfaction. Lidocaine, a local anesthetic with well-established safety profiles, offers a potential alternative to traditional analgesic methods. Research regarding lidocaine patches has been conducted in several types of surgeries (laparoscopy, gynecological surgery, prostatectomy, etc.) showing promising results for some. This study investigates the effectiveness of transdermal lidocaine 5% patches as a novel approach to postoperative analgesia after knee arthroscopy. Material and methods: a randomized, single-blind, placebo-controlled trial was conducted with participants undergoing knee arthroscopy. Patients were divided into two groups: one receiving transdermal lidocaine 5% patches and the other a placebo, both along traditional postoperative pain management, and using opioid only in cases with moderate-severe pain. Pain scores, opioid consumption, and patient-reported outcomes were assessed at various postoperative intervals. Results: there was a significant reduction in pain scores and opioid consumption in the lidocaine patch group compared to the placebo group. Conclusions: transdermal lidocaine 5% patches emerge as a promising adjunct to postoperative pain management in knee arthroscopy patients. Their ease of application, minimal side effects, and opioid-sparing effects contribute to a multifaceted analgesic approach. This study underscores the potential of transdermal lidocaine patches in enhancing the overall postoperative experience for knee arthroscopy patients, advocating for their consideration in clinical practice.

REFERENCES

1. Hashemi SM, Esmaeelijah A, Golzari S, Keyhani S, Maserrat A, Mohseni G, et al. Intravenous paracetamol versus patient-controlled analgesia with morphine for the pain management following diagnostic knee arthroscopy in trauma patients: a randomized clinical trial. Arch Trauma Res. 2015; 4(4): e30788.

2. Lee R. Local block for postoperative knee arthroscopy pain management: a retrospective study. AANA J. 2004; 72(6): 419-21.

3. Peng C, Li C, Yuan B, Jiao J. The efficacy of dexamethasone on pain management for knee arthroscopy: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020; 99(16): e19417.

4. Harirforoosh S, Asghar W, Jamali F. Adverse effects of nonsteroidal antiinflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications. J Pharm Pharm Sci. 2013; 16(5): 821-47.

5. Vadivelu N, Kai AM, Kodumudi V, Sramcik J, Kaye AD. The opioid crisis: a comprehensive overview. Curr Pain Headache Rep. 2018; 22(3): 16.

6. Hashmi JA, Baliki MN, Huang L, Parks EL, Chanda ML, Schnitzer T, et al. Lidocaine patch (5%) is no more potent than placebo in treating chronic back pain when tested in a randomised double blind placebo controlled brain imaging study. Mol Pain. 2012; 8: 29.

7. Galer BS, Sheldon E, Patel N, Codding C, Burch F, Gammaitoni AR. Topical lidocaine patch 5% may target a novel underlying pain mechanism in osteoarthritis. Curr Med Res Opin. 2004; 20(9): 1455-8.

8. Santana JA, Klass S, Felix ER. The efficacy, effectiveness and safety of 5% transdermal lidocaine patch for chronic low back pain: a narrative review. PM R. 2020; 12(12): 1260-7.

9. Cheng YJ. Lidocaine skin patch (Lidopat^® 5%) is effective in the treatment of traumatic rib fractures: a prospective double-blinded and vehicle-controlled study. Med Princ Pract. 2016; 25(1): 36-9.

10. Fiorelli A, Pace C, Cascone R, Carlucci A, De Ruberto E, Izzo AC, et al. Preventive skin analgesia with lidocaine patch for management of post-thoracotomy pain: Results of a randomized, double blind, placebo controlled study. Thorac Cancer. 2019; 10(4): 631-41.

11. Liu M, Wai M, Nunez J. Topical lidocaine patch for postthoracotomy and poststernotomy pain in cardiothoracic Intensive Care Unit Adult Patients. Crit Care Nurse. 2019; 39(5): 51-7.

12. Lee W, Hahn K, Hur J, Kim Y. Effect of topical lidocaine patch on postoperative pain management in laparoscopic appendectomy: a randomized, double-blind, prospective study. J Laparoendosc Adv Surg Tech A. 2018; 28(9): 1061-7.

13. Khanna M, Peters C, Singh JR. Treating pain with the lidocaine patch 5% after total knee arthroplasty. PM R. 2012; 4(9): 642-6.

14. Sadigursky D, de Castro Oliveira M, Gomes Macedo JG, Roque Paim Costa Junior F, Lemos Azi M, Figueiredo Alencar D. Effectiveness of lidocaine patches for pain treatment after total knee arthroplasty. MedicalExpress [Internet]. 2017; 4(6).

15. Gammaitoni AR, Alvarez NA, Galer BS. Pharmacokinetics and safety of continuously applied lidocaine patches 5%. Am J Health Syst Pharm. 2002; 59(22): 2215-20.

16. Wu X, Wei X, Jiang L, Cai J, Ju M, Zheng X. Is lidocaine patch beneficial for postoperative pain?: a meta-analysis of randomized clinical trials. Clin J Pain. 2023; 39(9): 484-90.

17. Elsayed AR, Elharty MA, Elgebaly AS. Efficacy and safety of lidocaine patch 5% supplementation to intra-articular bupivacaine dexmedetomidine after knee arthroscopy under general anesthesia: a randomized controlled study. Egypt J Anaesth. 2021; 37(1): 69-76.

18. Lee D, Campbell RE, Leider ML, Pepe MM, Tucker BS, Tjoumakaris FP. Efficacy of transdermal 4% lidocaine patches for postoperative pain management after arthroscopic rotator cuff repair: a prospective trial. JSES Int. 2021; 6(1): 104-10.

EVIDENCE LEVEL

I