Investig Clin Urol.  2018 Mar;59(2):141-147. 10.4111/icu.2018.59.2.141.

The safety of a mixture of bupivacaine and lidocaine in children after urologic inguinal and scrotal surgery

Affiliations
  • 1Department of Urology, Pusan National University School of Medicine, Yangsan, Korea. lsd@pusan.ac.kr
  • 2Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Abstract

PURPOSE
Local anesthetic agents such as bupivacaine and lidocaine are commonly used after surgery for pain control. The aim of this prospective study was to evaluate the safety of a mixture of bupivacaine and lidocaine in children who underwent urologic inguinal and scrotal surgery.
MATERIALS AND METHODS
Fifty-five patients who underwent pediatric urologic outpatient surgeries, were prospectively enrolled in this study. The patients were divided into three groups according to age (group I: under 2 years, group II: between 3−4 years, and group III: 5 years and above). Patients were further sub-divided into unilateral and bilateral groups. All patients were injected with a mixture of 0.5% bupivacaine and 2% lidocaine (2:1 volume ratio) at the surgical site, just before the surgery ended. Hemodynamic and electrocardiographic parameters were measured before local anesthesia, 30 minutes after administration of local anesthesia, and 60 minutes after administration.
RESULTS
The patients' mean age was 40.5±39.9 months. All patients had normal hemodynamic and electrocardiographic parameters before local anesthesia, after 30 minutes, and after 60 minutes. Also, results of all intervals were within normal values, when analyzed by age and laterality. No mixture related adverse events (nausea, vomiting, pruritus, sedation, respiratory depression) or those related to electrocardiographic parameters (arrhythmias and asystole) were reported in any patients.
CONCLUSIONS
A mixture of bupivacaine and lidocaine can be safely used in children undergoing urologic inguinal and scrotal surgery. An appropriate dose has no clinically significant hemodynamic or cardiac changes and adverse effects.

Keyword

Anesthesia, local; Bupivacaine; Lidocaine; Safety

MeSH Terms

Ambulatory Surgical Procedures
Anesthesia, Local
Anesthetics
Bupivacaine*
Child*
Electrocardiography
Hemodynamics
Humans
Lidocaine*
Prospective Studies
Pruritus
Reference Values
Vomiting
Anesthetics
Bupivacaine
Lidocaine

Reference

1. Machoki MS, Millar AJ, Albetyn H, Cox SG, Thomas J, Numanoglu A. Local anesthetic wound infusion versus standard analgesia in paediatric post-operative pain control. Pediatr Surg Int. 2015; 31:1087–1097. PMID: 26407616.
Article
2. Jarraya A, Elleuch S, Zouari J, Smaoui M, Laabidi S, Kolsi K. Postoperative analgesia in children when using clonidine in addition to fentanyl with bupivacaine given caudally. Pan Afr Med J. 2016; 24:182. PMID: 27795779.
Article
3. Krikava I, Jarkovský J, Stourac P, Nováková M, Sevcík P. The effects of lidocaine on bupivacaine-induced cardiotoxicity in the isolated rat heart. Physiol Res. 2010; 59(Suppl 1):S65–S69. PMID: 20626222.
Article
4. Bamigboye AA, Hofmeyr GJ. Local anaesthetic wound infiltration and abdominal nerves block during caesarean section for postoperative pain relief. Cochrane Database Syst Rev. 2009; (3):CD006954. PMID: 19588413.
Article
5. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003; 97:534–540. PMID: 12873949.
Article
6. Evans WN, Acherman RJ, Mayman GA, Rollins RC, Kip KT. Simplified pediatric electrocardiogram interpretation. Clin Pediatr (Phila). 2010; 49:363–372. PMID: 20118092.
Article
7. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006; 367:1618–1625. PMID: 16698416.
Article
8. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012; 116:248–273. PMID: 22227789.
9. Ruggiero A, Barone G, Liotti L, Chiaretti A, Lazzareschi I, Riccardi R. Safety and efficacy of fentanyl administered by patient controlled analgesia in children with cancer pain. Support Care Cancer. 2007; 15:569–573. PMID: 17146653.
Article
10. Jarzyna D, Jungquist CR, Pasero C, Willens JS, Nisbet A, Oakes L, et al. American Society for Pain Management Nursing guidelines on monitoring for opioid-induced sedation and respiratory depression. Pain Manag Nurs. 2011; 12:118–145.e10. PMID: 21893302.
Article
11. Aubrun F, Langeron O, Heitz D, Coriat P, Riou B. Randomised, placebo-controlled study of the postoperative analgesic effects of ketoprofen after spinal fusion surgery. Acta Anaesthesiol Scand. 2000; 44:934–939. PMID: 10981569.
Article
12. Alam A, Gomes T, Zheng H, Mamdani MM, Juurlink DN, Bell CM. Long-term analgesic use after low-risk surgery: a retrospective cohort study. Arch Intern Med. 2012; 172:425–430. PMID: 22412106.
13. Sahgal N, Khirwadkar R, Banerjee A. Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain. Br J Anaesth. 2011; 107:638. author reply 638-9. PMID: 21903646.
Article
14. Ekman EF, Wahba M, Ancona F. Analgesic efficacy of perioperative celecoxib in ambulatory arthroscopic knee surgery: a double-blind, placebo-controlled study. Arthroscopy. 2006; 22:635–642. PMID: 16762702.
Article
15. Agarwal A, Gautam S, Gupta D, Agarwal S, Singh PK, Singh U. Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth. 2008; 101:700–704. PMID: 18716003.
Article
16. Chang SH, Lee HW, Kim HK, Kim SH, Kim DK. An evaluation of perioperative pregabalin for prevention and attenuation of postoperative shoulder pain after laparoscopic cholecystectomy. Anesth Analg. 2009; 109:1284–1286. PMID: 19641054.
Article
17. Laskowski K, Stirling A, McKay WP, Lim HJ. A systematic review of intravenous ketamine for postoperative analgesia. Can J Anaesth. 2011; 58:911–923. PMID: 21773855.
Article
18. Marret E, Rolin M, Beaussier M, Bonnet F. Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br J Surg. 2008; 95:1331–1338. PMID: 18844267.
Article
19. Vigneault L, Turgeon AF, Côté D, Lauzier F, Zarychanski R, Moore L, et al. Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials. Can J Anaesth. 2011; 58:22–37. PMID: 21061107.
Article
20. Taddio A, Stevens B, Craig K, Rastogi P, Ben-David S, Shennan A, et al. Efficacy and safety of lidocaine-prilocaine cream for pain during circumcision. N Engl J Med. 1997; 336:1197–1201. PMID: 9110906.
Article
21. Pelter MM, Adams MG. Wide QRS duration. Am J Crit Care. 2004; 13:355–356. PMID: 15293590.
Article
22. Lee JY, Jo YY. Attention to postoperative pain control in children. Korean J Anesthesiol. 2014; 66:183–188. PMID: 24729838.
Article
23. Chung JM, Kim TN, Lee KM, Baik SW, Lee SD. Comparison of pain control method and assessment on postoperative pain in pediatric urological surgery of penoscrotal and inguinal regions. Korean J Urol. 2007; 48:163–170.
Article
Full Text Links
  • ICU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr