Research Day
TRANSDERMAL 4% LIDOCAINE PATCHES FOR POST-OPERATIVE PAIN MANAGEMENT FOLLOWING ARTHROSCOPIC ROTATOR CUFF REPAIR: A PROSPECTIVE, RANDOMIZED TRIAL
Document Type
Abstract
Date
2021
Abstract
Introduction: Multiple strategies have been investigated to decrease narcotic use following arthroscopic rotator cuff repair(RCR); post-operative lidocaine patch usage is one potential strategy. This study sought to determine the effectiveness of lidocaine patches in reducing post-operative pain following RCR.
Materials and Methods: This was a prospective, clinical trial evaluating the use of 4% trans-dermal lidocaine patches following RCR. Prospective recruitment occurred from the practice of three board certified, fellowship trained shoulder surgeons. Patients received interscalene nerve block and were prescribed 30 oxycodone(10mg). ASES(American and Shoulder Elbow Surgery) survey was completed pre-operatively and upto 6-months post-operatively. 14-day VAS(Visual Analog Scale) pain and medication log was completed three times daily. Results:80(40 control, 40 lidocaine) patients were enrolled. There was no difference in ASES scores pre-operatively(P=0.69; Lidocaine 50.68(+/- 26.14), Control 43.22(+/- 13.75)) or 6 months(P=0.68; Lidocaine 88.12(+/- 11.71), Control 89.55(+/- 8.87)). Mean consumption of opioids in MME(morphine milligram equivalents) did not differ between groups during the first 14 post-operative days.(P= 0.379; Lidocaine 81.03mg(+/- 95.11), Control 58.65mg(+/- 87.50)). Daily pain logs did not differ at any time point in regard to pain(P=0.16 to P=0.99). The lidocaine group reported significantly less satisfaction with their pain management from evening of post-operative day 2(P=0.048) through afternoon of POD8(P=0.029).
Conclusion: Transdermal 4% lidocaine patches are not effective in reducing pain or opioid consumption following arthroscopic rotator cuff repair. Additionally, patients utilizing this modality were more dissatisfied with their pain management for much of their initial post-operative course.