Journal of Clinical Nutrition & Dietetics

Lidocaine/Prilocaine cream Decreases Narcotic Use following Gastrostomy Placement: A Novel Pain Management Strategy for Children

Gastrostomy tube (gastrostomy) placement is an increasingly common procedure in children requiring alternative means of nutrition. Pediatric patients have been shown to tolerate percutaneous endoscopic gastrostomy (PEG) placement. Pain management is a chief concern in the care of children and often involves the use of opiates. Lidocaine/ Prilocaine cream (LPC) has demonstrated emerging effectiveness for pain management in a myriad of pediatric procedures with minimal side effects. Our study aims to determine whether LPC cream can decrease the need for narcotics during post-operative pain management following PEG pediatric patients.

Methods

This retrospective study involved the review of patient charts from January 2015 to May 2017 who underwent gastrostomy placement. Primary endpoints studied included demographic information, length of stay, medication reconciliation, complications, and hospital costs.

Results

59 patient records were reviewed for study inclusion (mean age 5.0±5.4 years, 57.6% male, and 15.0±12.1 kg). LPC was provided to 57% (n=34) subjects which was associated with decreased morphine milligram equivalent doses (MME), P=00.01, shorter hospitalization stay (mean days difference 13.74±5.62, median days difference=1), P=0.018 and decreased cost of hospitalization

Conclusion

Our study is the first to characterize the effectiveness of LPC cream in the management of post-operative pain following gastrostomy placement in pediatric patients. Our team demonstrated that patients with LPC cream, regardless of gastrostomy technique employed, required fewer weight-based MME doses, a shorter hospital stay, and decreased hospital costs.

Author(s):

Patrick Reeves1*; Travis Piester3; Lauren B. Del Bosque MPAS, PA-C3;James Aden, PhD4; R. Adam
Noel3; Javier J. Monagas3; James M. Noel3

Abstract | Full-Text | PDF

Share this