The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

Int Wound J. 2020 Apr;17(2):351-362. doi: 10.1111/iwj.13279. Epub 2019 Dec 13.

Abstract

To evaluate the efficacy of intravenous lidocaine in relieving postoperative pain and promoting rehabilitation in laparoscopic colorectal surgery, we conducted this meta-analysis. The systematic search strategy was performed on PubMed, EMBASE, Chinese databases, and Cochrane Library before September 2019. As a result, 10 randomised clinical trials were included in this meta-analysis (n = 527 patients). Intravenous lidocaine significantly reduced pain scores at 2, 4, 12, 24, and 48 hours on movement and 2, 4, and 12 hours on resting-state and reduced opioid requirement in first 24 hours postoperatively (weighted mean difference [WMD] = -5.02 [-9.34, -0.70]; P = .02). It also decreased the first flatus time (WMD: -10.15 [-11.20, -9.10]; P < .00001), first defecation time (WMD: -10.27 [-17.62, -2.92]; P = .006), length of hospital stay (WMD: -1.05 [-1.89, -0.21]; P = .01), and reduced the incidence of postoperative nausea and vomiting (risk ratio: 0.53 [0.30, 0.93]; P = .03) when compared with control group. However, it had no effect on pain scores at 24 and 48 hours at rest, the normal dietary time, and the level of serum C-reactive protein. In summary, perioperative intravenous lidocaine could alleviate acute pain, reduce postoperative analgesic requirements, and accelerate recovery of gastrointestinal function in patients undergoing laparoscopic colorectal surgery.

Keywords: intravenous lidocaine; laparoscopic colorectal surgery; perioperative.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Administration, Intravenous
  • Anesthetics, Local / administration & dosage
  • Colorectal Surgery / methods*
  • Humans
  • Laparoscopy / methods*
  • Lidocaine / administration & dosage*
  • Pain Measurement / methods
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy*
  • Recovery of Function*

Substances

  • Anesthetics, Local
  • Lidocaine