Efficacy of intravenous lidocaine on pain relief in patients undergoing laparoscopic cholecystectomy: A meta-analysis from randomized controlled trials

Abstract

Objective: Whether intravenous lidocaine has a beneficial role in controlling acute pain after a laparoscopic cholecystectomy (LC) in currently unknown. We performed a meta-analysis from randomized controlled trials (RCTs) to determine the efficacy and safety of intravenous lidocaine for the treatment of acute postoperative pain after LC.

Methods: In November 2017, a systematic search was performed in PubMed, EMBASE, Web of Science, ScienceDirect, and the Cochrane Library. RCTs comparing lidocaine and placebo in patients undergoing LC were retrieved. The primary endpoint was the visual analogue scale (VAS) score and opioid requirements at 12 h, 24 h and 48 h. The secondary endpoint was the length of hospital stay and opioid-related adverse effect. Stata 12.0 was used for the data analysis.

Results: Finally, six RCTs were included in the meta-analysis. Results indicated that intravenous lidocaine was associated with reduced pain scores and cumulative opioid consumption at 12 h, 24 h, and 48 h following a LC. Similarly, lidocaine was associated with a reduction in the incidence of nausea and vomiting, ileus and pruritus.

Conclusion: Intravenous use of lidocaine was able to reduce acute postoperative pain, total opioid requirements and opioid-related adverse effects following a LC. Further studies should determine whether lidocaine has a positive role in improving the postoperative function after a LC.

Keywords: Laparoscopic cholecystectomy; Lidocaine; Meta-analysis; Visual analogue scale.