Preliminary Experience With a Continuous Lidocaine Infusion as an Analgesia Adjunct for Acute Pain Management Following Surgery in Pediatric Patients

Deanna F. Couser, Catherine Roth, Miranda Holbrook, Sibelle Aurelie Yemele Kitio, Sharon Wrona, David Martin, Joseph D. Tobias


Background: Lidocaine is a local anesthetic of the amide class that has been used for various therapeutic interventions. Its potential analgesic effects have been reported in anecdotal reports and larger clinical trials.

Methods: We retrospectively reviewed our 24-month experience with the use of lidocaine outside of the intensive care unit (ICU) setting as an adjunct to acute pain management following major surgical procedures in children and adolescents.

Results: The study cohort included 168 patients (mean age 13.8 years). The majority of patients (N = 142) underwent a posterior spinal fusion for treatment of scoliosis (idiopathic or neuromuscular). Thirty-one patients received a bolus dose followed by an infusion starting at 0.2 to 2 mg/kg/h (average dose 0.97 mg/kg/h). Most patients (86.3%) received a continuous lidocaine infusion for 1 - 3 days at an average dose of 1 mg/kg/h. Lidocaine was infused for a total of 503 days in the study cohort of 168 patients. Despite that these were major surgical procedures, pain scores were generally acceptable. The lidocaine infusion was discontinued or decreased in eight patients due to concerns of adverse effects. Adverse effects were noted in 38 days of the 503 days of infusion (7.6%). A total of 29 patients (17.3%) experienced at least one adverse effect. The majority of these were related to the central nervous system (CNS) including blurred vision, dizziness, drowsiness/difficult to arouse, delirium, hallucinations, agitation, confusion, delirium, hallucinations, agitation, and confusion.

Conclusions: We present the largest study to date outlining the use of lidocaine as an adjunct to acute pain management in children and adolescents. These preliminary data suggest that with enhanced clinical observation for signs of potential toxicity and increased clinical monitoring of vital signs, the lidocaine infusion can be administered on the inpatient ward without routine serum concentration monitoring. The current cohort and other studies in pediatric patients provide a background for prospective studies to evaluate dosing regimens, optimal patient populations, and analgesic efficacy.

Int J Clin Pediatr. 2023;12(2):29-36


Lidocaine infusion; Multimodal analgesia; Acute pain; Postoperative analgesia

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics






International Journal of Clinical Pediatrics, quarterly, ISSN 1927-1255 (print), 1927-1263 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International
CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (
COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.