Preventive Skin Analgesia With Lidocaine Patch 5% for Controlling Post-thoracotomy Pain
Status:
Completed
Trial end date:
2015-12-01
Target enrollment:
Participant gender:
Summary
Thoracotomy is one of the most painful surgical incision. Uncontrolled acute post-thoracotomy
pain reducing deep breathing exercises and secretion clearance increased the incidence of
postoperative pulmonary complications including atelectasis, hypoxemia, and postoperative
pulmonary infections. Thus, an effective analgesia is crucial in order to reduce
perioperative morbidity and hospitalization time and also to prevent chronic post-thoracotomy
pain.
Thoracic epidural analgesia and thoracic paravertebral analgesia are currently the standard
strategies for thoracic surgery but the difficult of performing them in all patients and
their potential complications are all factors that limit their use. Systemic administration
of opioids is the simplest and common strategy to provide analgesia but it may be associated
with several undesirable effects, such as respiratory depression, sedation, nausea,
constipation and vomiting.
In the recent years, preventive analgesia is become one of the most promising strategy of
postoperative pain control. It is based on the concept of administering analgesic drugs
before the occurrence of nociceptive input in order to prevent central sensitization. The
efficacy of preemptive analgesia is unclear and there is no a consensus on its efficacy on
controlling pain after thoracic procedure.
Pain following thoracotomy has a multifactorial genesis including surgical incision,
intercostal nerve injury, pleural inflammation, and damage of pulmonary parenchyma and of
diaphragm. Thus, a multimodal analgesia that intercepts the signalizing at numerous locations
could be more effective than a single strategy targeting one site along the pain pathway.
Thus, in the present study, the clinical hypothesis was that the preemptive analgesia of the
skin using a new tool as the Lidocaine patch 5% would improve the analgesic effects of
systemic morphine analgesia for controlling post-operative pain following thoracotomy.
Phase:
N/A
Details
Lead Sponsor:
Second University of Naples University of Campania "Luigi Vanvitelli"