Perioperative Systemic Lidocaine for Postoperative Analgesia and Recovery after Laparoscopic Cholecystectomy: systematic review and meta-analyses of randomized controlled trials
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 9
Abstract
Laparoscopic cholecystectomy is one of the commonest operations in the world. Pain is a known significant factor to either delayed postoperative recovery or discharges. Improvement of perioperative outcomes remains huge challenge to perioperative clinicians. The aim of this review was to assess the effects of perioperative intravenous lidocaine infusion compared to placebo on postoperative pain and recovery in adults undergoing laparoscopic cholecystectomy. Methods Systematic review of literature conducted using electronic database searched up to November 2017 included Cochrane Central Register of Controlled trials in the Cochrane library, Medline, Embase and Science Citation Index Expanded database to identify relevant studies. Data extracted and critically appraised by two independent authors. In addition, random effects model were applied to calculated pooled results based on degree of heterogeneity. Results Five studies were finally included for systematic review and meta-analyses with 300 patients randomly assigned to either perioperative systemic lidocaine or control for postoperative analgesia and recovery after laparoscopic cholecystectomy. Findings were statistically significant in pain intensity in the lidocaine group WMD: -1.18mm (95% CI: -1.65, -0.72); I2=96% for pain intensity 1 to 4 hours after surgery WMD:-0.49mm (95%CI: -0.84, 0.14); I2=95% for postoperative pain intensity after 24 hours. Combined data showed reduced opioid consumption in the Lidocaine group compared with the control. WMD:--5.69mg (95% CI: -12.08, 0.70) I2=91%). In addition, the four studies gave data on opioid consumption intraoperative and in PACU. Three trials provided suitable data on the time to pass first flatus, significantly reduced in the lidocaine group. WMD:-5.14 hours (95%CI: -6.32, -3.96) I2=27%. Combined data from two studies favours lidocaine group with reduced time to first bowel movement. WMD:-9.10 hours (95% CI: -22.66, 4.46) I2=86%. PONV occurred in 18% of patients in the lidocaine group and 30% of patients in the control group (OR: 0.48(95%CI: 0.24, 0.96) I2=0% Conclusion Perioperative intravenous lidocaine may be an effective adjunct for postoperative pain management by decreasing postoperative pain severity, decreasing opioid consumption, less opioid related side effect and facilitate early GI function.
Authors and Affiliations
Akhigbe T
Keywords
Related Articles
- EP ID EP515739
- DOI -
- Views 75
- Downloads 0
Observation of Biochemical Changes Associated with Hepatitis B Virus Infection
Introduction: Hepatitis B is a viral disease with a high incidence and prevalence worldwide and it can cause acute and chronic liver disease. Aim: The present study was conducted to evaluate the some biochemical changes...
Surgical Sutures: the necessary update of current knowledge.
Objective: to describe the physical characteristics and biological of the wires of more suture used in surgical practice daily and their indications. Methods: review was conducted of literature through to search in the d...
Clinicopathological Study of Lower Gastrointestinal Tract Lesions in Per Rectal Bleeding Cases
Background: Rectal bleeding occurs in 20% of population in India. Rectal bleeding is mainly a manifestation of lower gastrointestinal tract lesions, which means bleeding from a site distal to ligament of Treitz, includin...
Acquired Pelger-Huet Anomaly and Altered morphology of neutrophils-in vivo Cytotoxicity in patients of sickle cell anaemia treated with hydroxyurea
Objectives & AIMS: The evaluation and identify new prognostic markers suggested in recent studies. Evaluate the relationship between morphological changes in neutrophils and sickle cell anaemia treated with hydroxyu...
Female Sterilisation Failure: Review over a Decade and Its Clinicopathological Correlation
Objectives: The primary objective of the following study is to determine the demographic patterns of women presenting as sterilization failure and secondary is to evaluate etiological factors for failure and lay standar...