BACKGROUND: This is an update of the review on 'Lidocaine for pain relief in burn injured patients' first published in Issue 3, 2007. Pain is a major issue for patients suffering from many different types of wounds, in particular those with burn injuries. Prompt, aggressive use of opioid analgesics such as morphine has been suggested as critical to avert the cycle of pain and anxiety, but side effects are encountered. It is proposed that newer agents such as lidocaine could be effective in reducing pain and alleviating the escalating opioid dosage requirements in patients with burn injury. OBJECTIVES: To assess the safety and effectiveness of intravenous lidocaine as a means of pain relief versus no therapy, placebo, other drugs or two or more of the above therapies in combination in patients exposed to burn injury. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2011, Issue 2), MEDLINE (1966 to April 2011 week 4) and EMBASE (1980 to 2011 week 17). SELECTION CRITERIA: We included randomised controlled trials (RCTs) and controlled clinical trials (CCTs), published and unpublished, which assessed the efficacy of intravenous lidocaine in varying doses as a single-agent therapy with no therapy, placebo, other analgesics such as opioids, lidocaine plus another drug, or two or more of the above therapies as a means of pain relief in patients exposed to burn injury. DATA COLLECTION AND ANALYSIS: Two review authors independently abstracted data and assessed the risk of bias of the studies identified. MAIN RESULTS: This update identified one new randomised, double-blind, placebo-controlled, cross-over trial which included 45 participants and compared intravenous lidocaine against placebo as a means of pain relief in those with burns. Subjective pain ratings as measured by the verbal rating scale increased during procedures for both treatment arms, however, the increase was less for the lidocaine treatment arm. There were no significant clinical or statistical differences regarding the effects of lidocaine and placebo on opioid requests and consumption, anxiety or level of satisfaction during a wound care procedure. AUTHORS' CONCLUSIONS: As current clinical evidence is based on only one single RCT as well as case series and reports, intravenous lidocaine must be considered a pharmacological agent under investigation in burns care, the effectiveness of which is yet to be determined with further well-designed and conducted clinical trials.
BACKGROUND: This is an update of the review on 'Lidocaine for pain relief in burn injured patients' first published in Issue 3, 2007. Pain is a major issue for patients suffering from many different types of wounds, in particular those with burn injuries. Prompt, aggressive use of opioid analgesics such as morphine has been suggested as critical to avert the cycle of pain and anxiety, but side effects are encountered. It is proposed that newer agents such as lidocaine could be effective in reducing pain and alleviating the escalating opioid dosage requirements in patients with burn injury. OBJECTIVES: To assess the safety and effectiveness of intravenous lidocaine as a means of pain relief versus no therapy, placebo, other drugs or two or more of the above therapies in combination in patients exposed to burn injury. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2011, Issue 2), MEDLINE (1966 to April 2011 week 4) and EMBASE (1980 to 2011 week 17). SELECTION CRITERIA: We included randomised controlled trials (RCTs) and controlled clinical trials (CCTs), published and unpublished, which assessed the efficacy of intravenous lidocaine in varying doses as a single-agent therapy with no therapy, placebo, other analgesics such as opioids, lidocaine plus another drug, or two or more of the above therapies as a means of pain relief in patients exposed to burn injury. DATA COLLECTION AND ANALYSIS: Two review authors independently abstracted data and assessed the risk of bias of the studies identified. MAIN RESULTS: This update identified one new randomised, double-blind, placebo-controlled, cross-over trial which included 45 participants and compared intravenous lidocaine against placebo as a means of pain relief in those with burns. Subjective pain ratings as measured by the verbal rating scale increased during procedures for both treatment arms, however, the increase was less for the lidocaine treatment arm. There were no significant clinical or statistical differences regarding the effects of lidocaine and placebo on opioid requests and consumption, anxiety or level of satisfaction during a wound care procedure. AUTHORS' CONCLUSIONS: As current clinical evidence is based on only one single RCT as well as case series and reports, intravenous lidocaine must be considered a pharmacological agent under investigation in burns care, the effectiveness of which is yet to be determined with further well-designed and conducted clinical trials.
Authors: Kathleen S Romanowski; Joshua Carson; Kate Pape; Eileen Bernal; Sam Sharar; Shelley Wiechman; Damien Carter; Yuk Ming Liu; Stephanie Nitzschke; Paul Bhalla; Jeffrey Litt; Rene Przkora; Bruce Friedman; Stephanie Popiak; James Jeng; Colleen M Ryan; Victor Joe Journal: J Burn Care Res Date: 2020-11-30 Impact factor: 1.845
Authors: Ralf Baron; Andreas Binder; Rolf Biniek; Stephan Braune; Hartmut Buerkle; Peter Dall; Sueha Demirakca; Rahel Eckardt; Verena Eggers; Ingolf Eichler; Ingo Fietze; Stephan Freys; Andreas Fründ; Lars Garten; Bernhard Gohrbandt; Irene Harth; Wolfgang Hartl; Hans-Jürgen Heppner; Johannes Horter; Ralf Huth; Uwe Janssens; Christine Jungk; Kristin Maria Kaeuper; Paul Kessler; Stefan Kleinschmidt; Matthias Kochanek; Matthias Kumpf; Andreas Meiser; Anika Mueller; Maritta Orth; Christian Putensen; Bernd Roth; Michael Schaefer; Rainhild Schaefers; Peter Schellongowski; Monika Schindler; Reinhard Schmitt; Jens Scholz; Stefan Schroeder; Gerhard Schwarzmann; Claudia Spies; Robert Stingele; Peter Tonner; Uwe Trieschmann; Michael Tryba; Frank Wappler; Christian Waydhas; Bjoern Weiss; Guido Weisshaar Journal: Ger Med Sci Date: 2015-11-12