IV Lidocaine vs. ESP Block for Postoperative Pain
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial examines two methods of using lidocaine for pain relief after heart surgery. One method delivers lidocaine through a catheter placed near the spine, while the other uses an intravenous (IV) route. Researchers aim to determine which method provides better pain relief. Individuals undergoing planned heart surgery, such as a coronary artery bypass graft (CABG) or valve surgery, and who speak English, may qualify for this trial. As a Phase 2 trial, the study measures the treatment's effectiveness in an initial, smaller group, allowing participants to contribute to important pain management research.
Will I have to stop taking my current medications?
The trial information does not specify if you need to stop taking your current medications. However, if you are dependent on narcotics (opioids) or have chronic pain, you may not be eligible to participate.
Is there any evidence suggesting that this trial's treatments are likely to be safe?
Research shows that the erector spinae plane (ESP) block with lidocaine is generally well-tolerated. A review of studies found it can reduce the need for painkillers like opioids after surgery and aid in faster recovery, such as quicker removal from a breathing machine and earlier mobility. However, limited information exists about its effects on children, so researchers mostly study it in adults.
For intravenous lidocaine, research has shown it can reduce pain after surgery and speed up recovery. A detailed review of many studies found it lessens pain soon after surgery. However, it must be used carefully, as rare reports of serious side effects have occurred if not used properly.
Both treatments have shown benefits in managing pain after surgery, but they should be used under medical supervision to ensure safety.12345Why are researchers excited about this trial's treatments?
Researchers are excited about these treatments because they explore two unique methods of delivering lidocaine for managing postoperative pain after cardiac surgery. Unlike the standard intravenous (IV) administration that is commonly used, the Erector Spinae Plane (ESP) Block involves a targeted delivery directly near the spine with the help of ultrasound guidance, potentially offering more localized pain control. This regional anesthetic technique might reduce the overall requirement for pain medications and enhance recovery. On the other hand, the intravenous administration of lidocaine remains the more familiar route but is being carefully compared to see if one method offers superior pain relief or fewer side effects. By investigating these approaches, researchers hope to optimize pain management and improve patient outcomes after heart surgeries.
What evidence suggests that this trial's treatments could be effective for postoperative pain?
This trial will compare two methods of administering lidocaine for postoperative pain management. Research has shown that using an erector spinae plane (ESP) block with lidocaine, which participants in one arm of this trial may receive, can reduce the need for opioids, lower pain levels, and delay the first request for pain relief after surgery. This method has been successful in various surgeries, aiding in pain management and speeding up recovery. In contrast, participants in another arm of this trial will receive intravenous lidocaine, known for reducing moderate-to-severe pain after surgery, especially during movement. Studies indicate it can effectively manage pain for up to 48 hours post-surgery. Both treatments hold promise for managing postoperative pain, with each offering advantages depending on the type of surgery.46789
Who Is on the Research Team?
Archit Sharma, MD
Principal Investigator
University of Iowa
Are You a Good Fit for This Trial?
This trial is for English-speaking adults scheduled for elective cardiac surgery through sternotomy, specifically CABG or valve surgery. It's not suitable for those unable to consent, prisoners, emergency cases, with psychiatric issues affecting consent, pregnant women, those with certain medical conditions like severe organ dysfunction or coagulation disorders, a BMI outside of 20-35 range, drug dependencies or chronic pain.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive either intravenous or erector spinae plane block administration of lidocaine for pain management post-cardiac surgery
Follow-up
Participants are monitored for safety and effectiveness after treatment, including pain scores and lidocaine plasma levels
What Are the Treatments Tested in This Trial?
Interventions
- Administration of Lidocaine Post Cardiac Surgery via ESP Catheter
- Intravenous Administration of Lidocaine Post Cardiac Surgery
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Who Is Running the Clinical Trial?
Archit Sharma
Lead Sponsor