BACKGROUND: Postoperative pain management remains a significant challenge after abdominal surgery.
OBJECTIVE: The aim of this meta-analysis was to evaluate the efficacy of systemic lidocaine for postoperative pain management and recovery after abdominal surgery.
DATA SOURCE: Data were derived from Medline (1966–2010), CINAHL, The Cochrane Central Register of Controlled Trials, and Scopus.
STUDY SELECTION: Randomized controlled trials of systemic administration of lidocaine for postoperative analgesia and recovery after abdominal surgery in adults, ie, >18 years, were considered.
INTERVENTIONS: Combined data were analyzed with use of a random-effects model.
MAIN OUTCOMES MEASURES: Data on opioid consumption, postoperative pain intensity, opioid-related side effects, time to first flatus, time to first bowel movement, and length of hospital stay were extracted.
RESULTS: Twenty-one trials comparing systemic lidocaine with placebo or blank control for postoperative analgesia and recovery after abdominal surgery were included in this meta-analysis. Weighted mean difference for cumulative analgesic opioid (morphine) consumption 48 hours after surgery was –7.04 mg (95% CI: –10.40, –3.68, I2 = 46.1%).Systemic lidocaine also significantly reduced postoperative pain intensity(visual analog scale, 0–100 mm) 6 hours after surgery at rest (weighted mean difference: –8.07 mm (95% CI: –14.69, –1.49); I2 = 90.6%) and during activity (weighted mean difference: –10.56 mm (95% CI: –16.89, –4.23), I2 = 82%). The time to first flatus and bowel movement was significantly shortened with lidocaine intervention by 6.92 hours (95% CI: –9.21, –4.63, I2 = 62.8%) and 11.74 hours (95% CI:–16.97, –6.51, I2 = 0). Moreover, systemic lidocaine also reduced hospital length of stay following the open procedure (weighted mean difference: –0.71 days (95% CI: –1.35, –0.07); I2 = 37.3%).
LIMITATIONS: Heterogeneity of study results is the main limitation of this meta-analysis.
CONCLUSION: Perioperative systemic lidocaine may be a useful adjunct for postoperative pain management by decreasing postoperative pain intensity, reducing opioid consumption, facilitating GI function, and shortening length of hospital stay.
1Department of Anesthesiology, TongRen Hospital, Capital Medical University, Beijing, China
2Department of Pediatrics, Stanford University School of Medicine, Stanford, California
3Department of Anesthesiology, ChaoYang Hospital, Capital Medical University, Beijing, China
4Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
Financial Disclosures: None reported.
Drs Sun and Li contributed equally to this article.
Disclaimers: The article represents the authors’ opinions, solely for medical communication.
Correspondence: Yanxia Sun, M.D., Department of Anesthesiology, TongRen Hospital, Capital Medical University, Beijing 100730 China. E-mail: firstname.lastname@example.org