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Analgesia for ICD?


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I know that in adult unventilated patients the trauma unit used to lavage the pleural space with lignocaine to achieve better analgesia for patients that required an intercostal drain.

Yesterday one of our 880grammers on NCPAP developed a pneumothorax large enough to qualify for a ICD. We were wondering if anybody tried the lignocaine lavage in unventilated prems? Apart from the theoretical danger of being absorbed systemically, it seemed like a good idea to save this unventilated baby some pain with breathing and the consequences eg collapse, apnoea, blood pressure fluctuations???

Comments would be appreciated.

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I know that in the Dutch NICU's there is no expericence with this kind of analgesia. The Dutch NICU's mainly use morphine (also in non-ventilated infants), and/or acetaminophen. Most use lidocaine as a local analgesic for thoracentesis.

Interesting topic though !

Best regards,

Christ-jan van Ganzewinkel

Neonatal Nurse Practitioner

Máxima Medical Centre, Veldhoven

The Netherlands

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  • 1 month later...

Morphine does not produce local analgesia and infiltration of lignocaine is necessary to provide local analgesia in addition to systemic morphine. I would be weary of using intrapleural lignocaine lavage though for its systemic absorption.

Dr Sanjeev Deshpande

Consultant Neonatologist

Royal Shrewsbury Hospital

Shrewsbury, UK

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