Is intravenous lidocaine effective for decreasing pain and speeding up recovery after surgery?

Medwave. 2017 Dec 29;17(9):e7121. doi: 10.5867/medwave.2017.09.7121.
[Article in Spanish, English]

Abstract

Introduction: Lidocaine is widely used in anesthesia due to its multiple properties, including its role as analgesic. However, it is not entirely clear which are the real benefits of its use in the perioperative setting.

Methods: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.

Results and conclusions: We identified 15 systematic reviews including 53 studies overall, all of them randomized controlled trials. We concluded the use of intravenous perioperative lidocaine probably results in a clinically irrelevant difference in pain and length of hospital stay, but it probably prevents postoperative nausea and vomiting.

Introducción: La lidocaína se utiliza ampliamente en el manejo anestésico debido a sus múltiples propiedades, especialmente analgésicas. Sin embargo, no está del todo claro cuáles son los reales beneficios de su utilización perioperatoria.

Métodos: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE.

Resultados y conclusiones: Identificamos 15 revisiones sistemáticas que en conjunto incluyen 53 estudios primarios, todos correspondientes a ensayos aleatorizados. Concluimos que el uso de lidocaína endovenosa perioperatoria probablemente resulta en una disminución clínicamente irrelevante del dolor y la duración de la estadía hospitalaria, pero que probablemente previene la presencia de náuseas y vómitos postoperatorios.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Administration, Intravenous
  • Analgesics / administration & dosage*
  • Analgesics / therapeutic use
  • Databases, Factual
  • Humans
  • Length of Stay
  • Lidocaine / administration & dosage*
  • Lidocaine / therapeutic use
  • Pain, Postoperative / drug therapy*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Analgesics
  • Lidocaine