Preliminary Experience With a Lidocaine Infusion as an Adjunct During Acute Pain Management Related to Medical Illnesses in Pediatric Patients
Bibliographic record
Abstract
Background: The potential analgesic effects of lidocaine have been reported in anecdotal reports and larger clinical trials in adults. However, there remains limited information regarding its use in pediatric-aged patients. In many institutions, continuous lidocaine infusions may be restricted to the pediatric intensive care unit (ICU) setting. This study assessed the safety and feasibility of the use of lidocaine outside the ICU setting as an adjunct for acute pain management related to medical conditions in pediatric patients. Methods: We retrospectively reviewed the outcomes of patients ≤ 21 years of age with acute medical illnesses, who received a continuous lidocaine infusion on the inpatient ward for the management of acute pain related to medical illnesses. Results: The study cohort included 15 patients who received a total of 46 lidocaine infusions during the study period. Patient ages ranged from 10 to 21 years (median age: 14 years, interquartile range (IQR): 13 - 20 years) with a median weight of 57.9 kg (IQR: 54 - 74 kg). The majority of encounters (n = 43, 94%) were for pain related to sickle cell disease. Most encounters (n = 31; 67%) received continuous lidocaine infusions for 1 - 7 days at a median dose of 1 mg/kg/h. Adverse events were noted on 11 of the 310 infusion days (4%), and at least one adverse event was reported in nine of the 46 encounters (20%). Infusion rate adjustments were made in six encounters (13%) due to adverse events. No adverse effects required escalation of the level of care. Conclusions: This study, which outlines our use of lidocaine as an adjunct to pain management for acute pain related to acute medical illnesses, expands on our previous work which described lidocaine for surgical pain. The study provides evidence toward the safety of pre-developed pathways and protocols for continuous lidocaine infusions outside the ICU setting, making lidocaine a feasible, non-opioid adjunct for the treatment of acute pain related to medical illnesses.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".