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Use of systemic lidocaine for postoperative acute pain management in single-lung transplantation: Case report
Lidocaína sistémica para el tratamiento del dolor agudo posoperatorio en trasplante unipulmonar. Reporte de caso
Palabras clave:
Acute Pain, Lung, Transplantation, Lidocaine, Metabolism (en)Dolor agudo, Pulmón, Trasplante, Lidocaína, Metabolismo (es)
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Introduction: Lung transplantation is associated with severe pain, which can delay recovery. Systemic lidocaine has useful analgesic properties for managing acute pain; however, little is known on its use after lung transplantation. Due to pharmacological alterations during the postoperative period, the use of analgesics implies a demanding process to avoid toxicity, so lidocaine may play a role in this scenario. In this sense, the purpose of this case report is to present the use of systemic lidocaine as an option for acute pain management when other analgesics fail.
Case presentation: The following is the case of a male patient with acute pain in the postoperative period of single-lung transplantation. Opioids and non-opioid analgesics showed limited efficacy, so systematic lidocaine was administered. Systemic administration of lidocaine was effective for pain control, functional recovery, and opioid decrease during the postoperative period.
Conclusions: Systemic administration of lidocaine was a useful alternative for achieving optimal postoperative pain management in lung transplantation, since it allowed adequate analgesia and lung function recovery with decreased use of opioids. This drug may be a component of multimodal analgesia in selected patients when other options fail however, its routine use is not recommended.
Introducción. El trasplante pulmonar se asocia con dolor severo, lo que puede retrasar la recuperación del paciente. La lidocaína sistémica tiene propiedades analgésicas útiles para el manejo del dolor agudo; sin embargo, su uso después del trasplante pulmonar es poco conocido. Debido a las alteraciones farmacológicas durante el período posoperatorio, el uso de analgésicos es un proceso exigente para evitar toxicidad, por lo que la lidocaína puede tener un rol en ese contexto. En este sentido, el objetivo del presente reporte es describir el uso de lidocaína sistémica como una opción para el manejo del dolor cuando otros analgésicos han fallado.
Presentación del caso. Paciente masculino con dolor severo en el posoperatorio de un trasplante unipulmonar. El uso de opioides y de analgésicos no opioides mostró una eficacia limitada, por lo que se decidió aplicar lidocaína sistémica, la cual fue efectiva para el control del dolor, la recuperación funcional y la disminución de opioides durante el período posoperatorio.
Conclusiones. La lidocaína sistémica fue un fármaco útil para el manejo del dolor posoperatorio del trasplante de pulmón, ya que permitió una analgesia adecuada y una recuperación funcional pulmonar con menor uso de opioides. Este fármaco puede ser parte de la analgesia multimodal en pacientes seleccionados cuando otras opciones analgésicas han fallado; sin embargo, no se recomienda su uso rutinario.
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Derechos de autor 2020 Revista de la Facultad de Medicina
Esta obra está bajo una licencia Creative Commons Reconocimiento 3.0 Unported.
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