Lidocaine Analgesia For Removal Of Wound Vac Dressings

University of Utah11 enrolled

Overview

The purpose of this prospective study is to compare pain levels and pain medication dose requirements in patients with topical negative pressure (TNP) dressings removed in a standard manner (i.v. or p.o. pain meds) compared to dressings removed with lidocaine analgesia, via injection retrograde up the suction tube into the foam prior to removal. Our null hypothesis is that there will be no difference in overall pain scores or medication requirements when patients receive a saline, control injection and pain medications, compared to when their dressings are changed with a lidocaine injection into the sponge, with pain medications. Our objective is to disprove this null hypothesis with statistical significance.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

TRIPLE

Enrollment

Conditions

Pain

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. wounds to which a split-thickness autologous skin graft applied; 2. infected wounds after debridement; 3. open fracture wounds; 4. acute soft-tissue wounds (with exposed tendon, bone, hardware, and/or joint); 5. fasciotomy wounds after compartment syndrome; 6. chronic non-healing wounds; 7. surgical wounds that are difficult to close due to tension; or 8. wounds with external fixation pins or tubes with irritation or drainage. Exclusion Criteria: 1. allergy to lidocaine; 2. allergy to the polyurethane foam or impermeable seal; 3. malignancy associated with the wound; 4. extremity insensate to pain due to any cause (including diabetic neuropathy, or any neurologic disorder therein); 5. pregnancy as diagnosed by urine pregnancy test.

Outcomes

Primary Outcomes

Visual Analog Scale Pain Score

Visial Analog Pain Scores (VAS) range from 0 (no pain) - 10 (worst pain ever). Visial Analog Pain Scores are determined at each pain measurement time point (during/after VAC dressing removal).

Time frame: 20 minutes

Secondary Outcomes

Break-through Narcotic Requirement

Patient break-through narcotic requirements in morphine equivalents are 0.2 mg of dilaudid = 1 mg of morphine, iv., used during and after VAC dressing change.