The purpose of this study is to find out if IV lidocaine infusion decreases the need of opioids, improves pain management, and reduces the risks of developing complications from prolonged opioid use in burn injury participants undergoing wound debridement in the operating room. Participants will: * be randomized to receive either an IV Lidocaine treatment or an IV Saline Placebo during their surgery. The IV treatment continues for 48 hours after surgery. * be asked about their pain and how they're feeling at 4 timepoints during the 48 hours. * be asked about their pain 2 weeks after surgery. The participant and medical care providers will both be blinded to what IV treatment is being received. Researchers will compare the 2 groups to see if IV Lidocaine helps decrease the need of opioids, improves pain management, and reduces the risks of developing complications from prolonged opioid use (this includes opioid tolerance, opioid dependence, and opioid induced hyper-sensitivity to pain).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
20
Participant receives IV Lidocaine during surgery. Infusion continues for 48 hours. An initial bolus dose of 1.5 mg/kg ideal body weight (IBW) of IV study infusion will be given at the start of surgery, followed by infusion rate of 2.0 mg/kg/hr IBW intraoperatively.This will be reduced to 1.5 mg/kg/hr IBW postoperatively for 48 hours - once the patient has reached recovery.
Participant receives IV Saline (placebo) during surgery. Infusion continues for 48 hours. An initial bolus dose of 1.5 mg/kg ideal body weight (IBW) of IV study infusion will be given at the start of surgery, followed by infusion rate of 2.0 mg/kg/hr IBW intraoperatively.This will be reduced to 1.5 mg/kg/hr IBW postoperatively for 48 hours - once the patient has reached recovery.
Feasibility of Study for future larger RCT-Recruitment
Recruitment rate (screening and recruitment of 20 patients over 6 months)
Time frame: Through study completion, an average of 6 months
Feasibility of Study for future larger RCT-Preliminary Data
Review of preliminary data for calculation of a sample size, minimum number of subjects needed to enroll in a future RCT for adequate power.
Time frame: Through study completion, an average of 6 months
Feasibility of Study for future larger RCT-Acceptability of Intervention
Review of randomization and blinding processes, including both patients and clinical provider's experience
Time frame: Through study completion, an average of 6 months
Feasibility of Study for future larger RCT-Data collection
The suitability of the methods for data collection, which are In person visits at 24, 48 \& 72hr and likely phone/virtual follow-ups at 2 weeks and 3 months
Time frame: Through study completion, an average of 6 months
Feasibility of Study for future larger RCT-Reliability of data
The reliability of data collected for analysis of analgesic efficacy includes review of numerical pain scores, total morphine equivalent dose (MED), Quality of Recovery Scores (QoR-15), and Brief Pain Inventory (BPI). Analgesic efficacy is expressed as the NNT, the number of patients who need to receive the active drug for one to achieve at least 50% pain relief compared with placebo over a 4-6h treatment period.
Time frame: Through study completion, an average of 6 months
Feasibility of Study for future larger RCT-Outcomes
Review of current Secondary Outcome to determine if appropriate to become Primary Outcomes for future RCT
Time frame: Through study completion, an average of 6 months
Feasibility of Study for future larger RCT-Complete Data collection
Determine completion rate of collected data
Time frame: Through study completion, an average of 6 months
Length of Hospital Stay
This is calculated from the date admitted to the hospital to the date of hospital discharge.
Time frame: Up to 50 weeks
Adverse effects of lidocaine infusion
Time frame: 48 hours - During the lidocaine infusion
Total MED
MED=Morphine Equivalent Dose. MED are values that represent the potency of an opioid dose relative to morphine. MED equates the many different opioids into a standard value that is based on morphine and its potency.
Time frame: MED assessed at 24-, 48-, and 72-hours post-operatively
Pain Scores
Pain Scores at rest and at movement provided by participant will be a numerical pain score from 0-10, with 0=no pain and 10-worst pain imaginable.
Time frame: Scores assessed at 24-, 48-, and 72-hours post-operatively
Quality of Recovery Scores
The Quality of Recovery-15 (QoR-15) is a patient-reported outcome measurement measuring QoR after surgery and anesthesia. The scale is arbitrary and ranges from 0-150 with 4 severity classes; excellent, good, moderate, and poor recovery.
Time frame: Assessed 24-, 48-, and 72-hours post-operatively
Brief Pain Inventory (Short Form)
The Brief Pain Inventory-Short Form (BPI) is a 9-item self-administered questionnaire which rapidly assesses the severity of pain and it's impact on functioning.
Time frame: Assessed at 2 weeks post-operatively and at 3 months post-operatively
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