Efficacy of intraoperative intravenous lidocaine for postoperative analgesia following bariatric surgery: a meta-analysis of randomized controlled studies

doi:10.1016/j.soard.2021.08.014

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Title:	Efficacy of intraoperative intravenous lidocaine for postoperative analgesia following bariatric surgery: a meta-analysis of randomized controlled studies
Authors:	Hung, Kuo-Chuan Chang, Ying-Jen Chen, I-Wen Chang, Yang-Pei Chiu, Sheng-Fu Sun, Cheuk-Kwan
Contributors:	Chi Mei Med Ctr, Dept Anesthesiol Chia Nan Univ Pharm & Sci, Gen Educ Ctr Chia Nan Univ Pharm & Sci,Dept Recreat & Hlth Care Management Kaohsiung Med Univ, Kaohsiung Municipal Ta Tung Hosp, Dept Neurol Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Neurol Chi Mei Hosp, Dept Oral & Maxillofacial Surg E Da Hosp, Dept Emergency Med I Shou Univ, Coll Med
Keywords:	Laparoscopic bariatric surgery Lidocaine Opioid Quality of recovery
Date:	2021
Issue Date:	2023-11-11 11:42:43 (UTC+8)
Publisher:	ELSEVIER SCIENCE INC
Abstract:	Background: The impact of intravenous lidocaine in adults undergoing laparoscopic bariatric sur-geries (LBS) remains unclear. Objectives: This study aimed at investigating the effect of intravenous lidocaine on postoperative opioid consumption and recovery following LBS. Setting: Meta-analysis. Methods: We searched databases including MEDLINE, Embase, Google Scholar, and the Cochrane Library for randomized controlled trials that evaluated the use of intravenous lidocaine compared to placebo only prior to May 2021. The primary outcome was 24-hour postoperative opioid consump-tion, while secondary outcomes included pain score, quality of recovery (QOR)-40 score, length of hospital stay (LOS), and postoperative nausea/vomiting (PONV). Results: Seven trials (496 participants) were included. Intraoperative intravenous lidocaine signif-icantly reduced 24-hour equivalent morphine consumption (mean difference [MD]: -11.97 mg; 95% confidence interval [CI]: -23.12 to -.83), pain score at 1 to 3 hours (MD: -.77; 95% CI: -1.5 to -.04), and LOS (MD: -8.93 hr; 95% CI: -13.41 to -4.44) without positive impact on 24-hour pain score and PONV. There was also an increase in time to first opioid requirement (MD: 20.23 min; 95% CI: 11.76-28.7) and QOR-40 score (MD: 24.38; 95% CI: 5.57-43.18). How-ever, sensitivity analysis demonstrated evidence supporting the beneficial effect of lidocaine only for time to first opioid requirement and QOR-40. The associations of intraoperative intravenous lidocaine with reductions in morphine consumption, pain score at 1 to 3 hours, and LOS after LBS were also weak. Conclusion: Intraoperative intravenous lidocaine during LBS prolonged time to first opioid require-ment and improved quality of recovery postoperatively without 24-hour pain or nausea/vomiting benefits. Due to the small number of trials, larger studies are warranted to verify our findings. (C) 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Relation:	SURG OBES RELAT DIS, v.18, n.1, pp.135-147
Appears in Collections:	[The Center For General Education] Periodical Articles [Dept. of Recreation and Health-Care Management] Periodical Articles

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