Uso da lidocaína venosa em pacientes pediátricos submetidos à tonsilectomia: analgesia pós-operatória

Abstract

Tonsillectomy is one of the most commonly performed surgical procedures in pediatric patients. A major limitation to the hospital discharge is the postoperative pain, which is severe in up 50% of the children. Systemic lidocaine has antiinflammatory, analgesic and antihyperalgesic properties. Studies show the efficacy of endovenous lidocaine as a strategy to decreased postoperative pain, being able to reduce the intra and postoperative analgesic requirement in many types of surgery. This study evaluated the use of perioperative systemic lidocaine to reduce pain in patients undergoing tonsillectomy with or without adenoidectomy. It is a prospective, randomized, double-blinded study involving 14 patients, who were divided into control group and lidocaine group. We evaluated the visual analogue scale (VAS) at rest and during swallowing at the times 1, 3, 6, 12, 18 hours after surgery and at hospital discharge, the need for rescue analgesia, opioid consumption, quality of awakening and the time for diet reintroduction. There was no difference between groups in postoperative pain. The average VAS at rest was 1.4 in the control group and 1.29 in the lidocaine group. Swallowing pain was 2.5 in the control group and 2.78 in the lidocaine group. There was no difference between groups neither in total analgesics consumption nor quality of awakening or time for diet reintroduction. Perioperative administration of systemic lidocaine did not reduce the VAS or opioid consumption between groups.