• Vanessa Rousseau, Magali Morelle, Céline Arriuberge, Sophie Darnis, Sylvie Chabaud, Valérie Launay, Sandrine Thouvenin, Fabienne Roumenoff-Turcant, Séverine Metzger, Barbara Tourniaire, and Perrine Marec-Berard.
• Emergency Department and Pediatric Resuscitation, Civil Hospitals of Lyon, Mother-Child Hospital, Bron, France.
• Pain Pract. 2018 Jul 1; 18 (6): 788-797.

BackgroundThe management of neuropathic pain and pain related to bone vaso-occlusive crises in sickle cell disease remains challenging in children. Lidocaine 5% patches are recommended in adults for neuropathic pain treatment, but they are not recommended in children. The purpose of this study was to assess the efficacy and tolerance of lidocaine 5% patches in pediatric inpatients.MethodsThis prospective, multicenter, single-arm, phase II study aimed to assess the use of lidocaine 5% patches in 6- to 21-year-old pediatric patients suffering from neuropathic pain or superficial bone vaso-occlusive crises. Patches were applied on the painful area for 12 hours a day. The primary endpoint was the proportion of inpatients with significant pain relief defined as a decrease of at least 2 points on the visual analog pain scale (VAS) measured at 12 hours after patch placement over at least 2 consecutive days.ResultsThe 12-hour VAS score decreased by at least 2 points over 2 consecutive days in 48.6% of patients 95% unilateral confidence interval (33.8%). Only 7.7% of patients experienced grade 1 or grade 2 toxicities.ConclusionAlthough lidocaine 5% patches decreased the pain's intensity in nearly half of the enrolled patients with an excellent tolerance, the efficacy endpoint was not reached. Further studies should consider a more refined selection of the experimental population to assess the efficacy of lidocaine 5% patches in the pediatric population.© 2017 World Institute of Pain.

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