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Effect of lidocaine on kanamycin injection-site pain in patients with multidrug-resistant tuberculosis
OBJECTIVE AND DESIGN: We performed a randomised single-blinded crossover study to determine if lidocaine reduces KM injection-site pain. We recruited patients aged 18 years on MDR-TB treatment at two TB hospitals in Cape Town, South Africa. KM pharmacokinetic parameters and a validated numeric pain scale were used at intervals over 10 h following the injection of KM with and without lidocaine on two separate occasions.
RESULTS: Twenty participants completed the study: 11 were males, the median age was 36 years, 11 were HIV-infected, and the median body mass index was 17.5 kg/m2. The highest pain scores occurred early, and the median pain score was 0 by 30 min. The use of lidocaine with KM significantly reduced pain at the time of injection and 15 min post-dose. On multiple regression analysis, lidocaine halved pain scores (adjusted OR 0.5, 95%CI 0.3–0.9). The area under the curve at 0–10 h of KM with and without lidocaine was respectively 147.7 and 143.6 μg·h/ml.
CONCLUSION: Lidocaine significantly reduces early injection-site pain and has no effect on KM pharmacokinetics.
Keywords: TB; adherence; adverse effect; injectable
Document Type: Research Article
Affiliations: 1: Division of Clinical Pharmacology, Department of Medicine 2: Clinical Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town 3: Brooklyn Chest Hospital, Cape Town 4: D P Marais Hospital, Cape Town, South Africa 5: Center for Infectious Diseases Research and Experimental Therapeutics, Baylor Research Institute, Baylor University Medical Center, Dallas, Texas, USA
Publication date: August 1, 2018
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.
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