Safety and Tolerability of Intravenous Lidocaine Infusions as Opioid Adjunct for Children Hospitalized With Sickle Cell Vaso-Occlusive Pain.
Agbakwuru U, AuBuchon JD, Toebe B, LaBarge A, Di Paola J , et al.
Pediatric blood & cancer •
Sickle cell disease (SCD) vaso-occlusive episode (VOE) pain is treated with opioids, and non-opioid adjuvants may reduce pain severity without opioid side effects. We retrospectively investigated the safety and tolerability of intravenous lidocaine infusions as an adjunct to opioids in children and adolescents during VOE hospitalizations. In 2 years, lidocaine was administered in 64.6% of 260 admissions. There were no serious toxicities; overall, 82.2% of recipients chose to receive lidocaine during subsequent admissions. Lidocaine infusions were associated with longer hospitalizations, potentially reflecting selection bias. The efficacy of adjuvant lidocaine infusions during VOE should be studied prospectively.