Document Detail


Perioperative systemic lidocaine for postoperative analgesia and recovery after abdominal surgery: a meta-analysis of randomized controlled trials.
MedLine Citation:
PMID:  23044681     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Yanxia Sun; Tianzuo Li; Nan Wang; Yue Yun; Tong J Gan
Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  55     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-09     Completed Date:  2012-12-21     Revised Date:  2013-02-07    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1183-94     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, TongRen Hospital, Capital Medical University, Beijing 100730, [corrected] China. sun00017@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Abdomen / surgery*
Analgesics / administration & dosage*
Analgesics, Opioid / therapeutic use
Defecation
Humans
Infusions, Intravenous
Intestine, Large / physiology*
Length of Stay
Lidocaine / administration & dosage*
Pain, Postoperative / drug therapy*
Randomized Controlled Trials as Topic
Recovery of Function / drug effects
Time Factors
Chemical
Reg. No./Substance:
0/Analgesics; 0/Analgesics, Opioid; 137-58-6/Lidocaine
Comments/Corrections
Erratum In:
Dis Colon Rectum. 2013 Feb;52(2):271

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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