Dexmedetomidine Versus Lidocaine for Postoperative Analgesia in Pediatric Patients Undergoing Craniotomy: a Protocol for a Prospective, Randomized, Double-blinded, Placebo-controlled Trial

Abstract

Background: Postoperative pain is a common problem that occurs in pediatric patients following neurosurgery which may lead to severe complications. Dexmedetomidine is a commonly used adjuvant medicine in craniotomy owing to its sedative, amnestic, analgesic, and neuroprotective properties. Besides, studies suggest that lidocaine has similar effects on sedation, analgesia, and neuroprotection. Both two adjuvants can reduce postoperative pain after neurosurgery in adults. However, it is still unknown whether dexmedetomidine or lidocaine can reduce postoperative pain in children undergoing craniotomy and if yes, which is a better medicine choice. Therefore, we aimed to compare the effect of dexmedetomidine vs. lidocaine on postoperative pain in pediatric patients after craniotomy. Methods/design: We will perform a randomized (1:1:1), double-blind, placebo-controlled, single-center trial. Children aged 1–12 years scheduled for craniotomy will be eligible for inclusion. The 255 recruited participants will be stratified by age in two strata (1–6 years and 7–12 years), and then each stratum will be equally randomized to three groups: Group D (infusion of dexmedetomidine [intervention group]), Group L (infusion of lidocaine [intervention group]), and Group C (infusion of normal saline [control group]). Patients will be followed-up at 1 h, 2 h, 4 h, 24 h, and 48 h after surgery. The primary outcome will be total sufentanil consumption within 24 h after surgery.Discussion: In this clinical trial, we expect to clarify and compare the postoperative analgesic effect of dexmedetomidine vs. lidocaine infusion on pediatric patients undergoing craniotomy. We believe that the results of this trial will provide more choices for postoperative analgesia for the pediatric population.Trial registration: Chinese ClinicalTrials.gov Identifier: ChiCTR1800019411. Registered 10 November 2018. Registered with the name of “A randomized double-blind controlled trial for low-dose dexmedetomidine and lidocaine in the treatment of post-craniotomy pain in children” URL: http://www.chictr.org.cn/showproj.aspx?proj=32822