Highlights
- •Post-sternotomy pain (PSP) is one of the major postoperative complaints after cardiac surgery.
- •The 5% lidocaine patches were applied to the bilateral side of the sternotomy site.
- •The 5% lidocaine patch can reduce PSP and the use of additional opioids without causing significant adverse effects.
Abstract
Purpose
Poststernotomy pain (PSP), a primary concern after sternotomy, can negatively affect
patients' satisfaction with surgery and quality of life. Many clinical trials have
been conducted to examine the usefulness of lidocaine patches (LPs) for postoperative
pain control for multiple types of surgery; however, the results of these trials are
inconsistent. In addition, little is known about the use of LPs after cardiac procedures
that require sternotomy. This prospective, double-blind, placebo-controlled trial
aimed to determine the efficacy of the 5% LP application at the sternotomy site for
reducing PSP and rescue opioid consumption.
Methods
The patients were randomly assigned to receive either the 5% LP or the placebo patch
on each side of the incision site immediately after the surgery. The intensity of
pain at 6, 12, 24, and 48 h after the patch application; the total dose of rescue
opioids; incidence of nausea, vomiting, and sleep disturbance; and use of antiemetics
were compared between the 2 groups.
Findings
Fifty-seven (31 in the LP group and 26 in the placebo group) patients were included.
The pain intensity was significantly lower in the LP group at each time point (66%–68%
pain reduction, P < 0.001, interaction of time × treatment P = 0.69). In addition, the total dose of rescue opioids used for 48 h was significantly
lower in the L group (27.2% reduction, P = 0.008). No significant differences were found in other outcome variables between
the 2 groups.
Implications
The application of a 5% LP on each side of the sternotomy site can reduce PSP and
additional opioid use without significant adverse effects in patients undergoing sternotomy.
Thus, it can be considered as a standard and routine modality along with other analgesic
medications for the management of PSP. Clinical Trial Registry in South Korea identifier:
KCT0000476.
Key words
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Article info
Publication history
Published online: November 20, 2020
Accepted:
October 31,
2020
Identification
Copyright
© 2020 Elsevier Inc.
