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Meta-Analysis
. 2018 Jun 4;6(6):CD009642.
doi: 10.1002/14651858.CD009642.pub3.

Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults

Stephanie Weibel  1 , Yvonne Jelting, Nathan L Pace, Antonia Helf, Leopold Hj Eberhart, Klaus Hahnenkamp, Markus W Hollmann, Daniel M Poepping, Alexander Schnabel, Peter Kranke
Affiliations
Meta-Analysis

Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults

Stephanie Weibel et al. Cochrane Database Syst Rev. .

Abstract

Background: The management of postoperative pain and recovery is still unsatisfactory in a number of cases in clinical practice. Opioids used for postoperative analgesia are frequently associated with adverse effects, including nausea and constipation, preventing smooth postoperative recovery. Not all patients are suitable for, and benefit from, epidural analgesia that is used to improve postoperative recovery. The non-opioid, lidocaine, was investigated in several studies for its use in multimodal management strategies to reduce postoperative pain and enhance recovery. This review was published in 2015 and updated in January 2017.

Objectives: To assess the effects (benefits and risks) of perioperative intravenous (IV) lidocaine infusion compared to placebo/no treatment or compared to epidural analgesia on postoperative pain and recovery in adults undergoing various surgical procedures.

Search methods: We searched CENTRAL, MEDLINE, Embase, CINAHL, and reference lists of articles in January 2017. We searched one trial registry contacted researchers in the field, and handsearched journals and congress proceedings. We updated this search in February 2018, but have not yet incorporated these results into the review.

Selection criteria: We included randomized controlled trials comparing the effect of continuous perioperative IV lidocaine infusion either with placebo, or no treatment, or with thoracic epidural analgesia (TEA) in adults undergoing elective or urgent surgery under general anaesthesia. The IV lidocaine infusion must have been started intraoperatively, prior to incision, and continued at least until the end of surgery.

Data collection and analysis: We used Cochrane's standard methodological procedures. Our primary outcomes were: pain score at rest; gastrointestinal recovery and adverse events. Secondary outcomes included: postoperative nausea and postoperative opioid consumption. We used GRADE to assess the quality of evidence for each outcome.

Main results: We included 23 new trials in the update. In total, the review included 68 trials (4525 randomized participants). Two trials compared IV lidocaine with TEA. In all remaining trials, placebo or no treatment was used as a comparator. Trials involved participants undergoing open abdominal (22), laparoscopic abdominal (20), or various other surgical procedures (26). The application scheme of systemic lidocaine strongly varies between the studies related to both dose (1 mg/kg/h to 5 mg/kg/h) and termination of the infusion (from the end of surgery until several days after).The risk of bias was low with respect to selection bias (random sequence generation), performance bias, attrition bias, and detection bias in more than 50% of the included studies. For allocation concealment and selective reporting, the quality assessment yielded low risk of bias for only approximately 20% of the included studies.IV Lidocaine compared to placebo or no treatment We are uncertain whether IV lidocaine improves postoperative pain compared to placebo or no treatment at early time points (1 to 4 hours) (standardized mean difference (SMD) -0.50, 95% confidence interval (CI) -0.72 to -0.28; 29 studies, 1656 participants; very low-quality evidence) after surgery. Due to variation in the standard deviation (SD) in the studies, this would equate to an average pain reduction of between 0.37 cm and 2.48 cm on a 0 to 10 cm visual analogue scale . Assuming approximately 1 cm on a 0 to 10 cm pain scale is clinically meaningful, we ruled out a clinically relevant reduction in pain with lidocaine at intermediate (24 hours) (SMD -0.14, 95% CI -0.25 to -0.04; 33 studies, 1847 participants; moderate-quality evidence), and at late time points (48 hours) (SMD -0.11, 95% CI -0.25 to 0.04; 24 studies, 1404 participants; moderate-quality evidence). Due to variation in the SD in the studies, this would equate to an average pain reduction of between 0.10 cm to 0.48 cm at 24 hours and 0.08 cm to 0.42 cm at 48 hours. In contrast to the original review in 2015, we did not find any significant subgroup differences for different surgical procedures.We are uncertain whether lidocaine reduces the risk of ileus (risk ratio (RR) 0.37, 95% CI 0.15 to 0.87; 4 studies, 273 participants), time to first defaecation/bowel movement (mean difference (MD) -7.92 hours, 95% CI -12.71 to -3.13; 12 studies, 684 participants), risk of postoperative nausea (overall, i.e. 0 up to 72 hours) (RR 0.78, 95% CI 0.67 to 0.91; 35 studies, 1903 participants), and opioid consumption (overall) (MD -4.52 mg morphine equivalents , 95% CI -6.25 to -2.79; 40 studies, 2201 participants); quality of evidence was very low for all these outcomes.The effect of IV lidocaine on adverse effects compared to placebo treatment is uncertain, as only a small number of studies systematically analysed the occurrence of adverse effects (very low-quality evidence).IV Lidocaine compared to TEAThe effects of IV lidocaine compared with TEA are unclear (pain at 24 hours (MD 1.51, 95% CI -0.29 to 3.32; 2 studies, 102 participants), pain at 48 hours (MD 0.98, 95% CI -1.19 to 3.16; 2 studies, 102 participants), time to first bowel movement (MD -1.66, 95% CI -10.88 to 7.56; 2 studies, 102 participants); all very low-quality evidence). The risk for ileus and for postoperative nausea (overall) is also unclear, as only one small trial assessed these outcomes (very low-quality evidence). No trial assessed the outcomes, 'pain at early time points' and 'opioid consumption (overall)'. The effect of IV lidocaine on adverse effects compared to TEA is uncertain (very low-quality evidence).

Authors' conclusions: We are uncertain whether IV perioperative lidocaine, when compared to placebo or no treatment, has a beneficial impact on pain scores in the early postoperative phase, and on gastrointestinal recovery, postoperative nausea, and opioid consumption. The quality of evidence was limited due to inconsistency, imprecision, and study quality. Lidocaine probably has no clinically relevant effect on pain scores later than 24 hours. Few studies have systematically assessed the incidence of adverse effects. There is a lack of evidence about the effects of IV lidocaine compared with epidural anaesthesia in terms of the optimal dose and timing (including the duration) of the administration. We identified three ongoing studies, and 18 studies are awaiting classification; the results of the review may change when these studies are published and included in the review.

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Conflict of interest statement

Stephanie Weibel: none known.

Yvonne Jelting: none known.

Nathan Leon Pace: has no conflict of interest regarding the topic of this review. Nathan L Pace has received payment for development of educational presentations (Barash, Cullen, Stoelting Clinical Anesthesia 8th edition) and provided consultancy (St Marks Hospital, Salt Lake City, UT) on topics not related to the current review. He has received supplements to attend Cochrane meetings. He also has stocks and shares in companies which have no interest in the topic of this review (TIAA‐CREF, Fidelity, Vanguard, USAA, Morgan Stanley).

Antonia Helf: none known.

Leopold HJ Eberhart: has no conflict of interest regarding the topic of this review. Leopold HJ Eberhart has received lecture fees (from Baxter GmbH and Fresenius GmbH), payment for lectures (from Grünenthal GmbH, Baxter GmbH and Fresenius, GmbH) and has provided consultancy (for Grünenthal GmbH, Baxter GmbH, ratiopharm GmbH) for topics not related to the current review. He holds a board membership (with Grünenthal GmbH Deutschland) who do not have an interest in the topic of this review.

Klaus Hahnenkamp: is working in this research area and has participated in a clinical study that is relevant for this systematic review (Herroeder 2007). Critical appraisal and data extraction were done by JJ and SW.

Markus W Hollmann: is working in this research area and has participated in a clinical study that is relevant for this systematic review (Herroeder 2007). Critical appraisal and data extraction were done by JJ and SW.

Daniel M Poepping: none known.

Alexander Schnabel: none known.

Peter Kranke: has no conflict of interest regarding the topic of this review. Peter Kranke has received lecture fees (from FreseniusKabi, MSD, Ratiopharm, Covidien) and has provided consultancy (to MSD, FreseniusKabi, Ratiopharm, Covidien) on topics not related to the current review. He has been involved in the conduct of Phase II and phase III clinical trials not related to the current review.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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Grady 2012 {published data only}
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Grigoras 2012 {published data only}
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Herroeder 2007 {published data only}
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Insler 1995 {published data only}
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Ismail 2008 {published data only}
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Kaba 2007 {published data only}
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Koppert 2004 {published data only}
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Kuo 2006 {published data only}
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Lauwick 2008 {published data only}
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Maquoi 2016 {published data only}
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Saadawy 2010 {published data only}
    1. Saadawy IM, Kaki AM, Abd El Latif AA, Abd‐Elmaksoud AM, Tolba OM. Lidocaine vs. magnesium: effect on analgesia after a laparoscopic cholecystectomy. Acta Anaesthesiologica Scandinavica 2010;54(5):549‐56. [PUBMED: 19919581] - PubMed
Samimi 2015 {published data only}
    1. Samimi S, Taheri A, Davari Tanha F. Comparison between intraperitoneal and intravenous lidocaine for postoperative analgesia after elective abdominal hysterectomy, a double‐blind placebo controlled study. Journal of Family and Reproductive Health 2015;9(4):193‐8. [1735‐8949; PUBMED: 27047566] - PMC - PubMed
Slovack 2015 {unpublished data only}
    1. NCT01277835. Intravenous lidocaine infusion during video‐assisted thoracic procedures for improved pain control [Intravenous lidocaine infusion during VATS procedures reduces postoperative analgesic requirements]. clinicaltrials.gov/ct2/show/NCT01277835 (first received 17 January 2011 ).
    1. Slovack M, Taylor B, Bryce R, Ong D. Does intravenous lidocaine infusion during video‐assisted thoracoscopic surgery reduce postoperative analgesia? A randomized controlled study. Canadian Journal of Anaesthesia 2015;62(6):676‐7. - PubMed
Soltani 2013 {published data only}
    1. Soltani HA, Nasr M, Siadat ZD. Effects of lidocaine on reducing the need for anesthetic drugs during ophthalmologic surgeries. Journal of Isfahan Medical School 2013;31(224):41‐9.
Sridhar 2015 {published data only}
    1. Sridhar P, Sistla SC, Ali SM, Karthikeyan VS, Badhe AS, Ananthanarayanan PH. Effect of intravenous lignocaine on perioperative stress response and post‐surgical ileus in elective open abdominal surgeries: a double‐blind randomized controlled trial. ANZ Journal of Surgery 2015;85(6):425‐9. [1445‐2197; PUBMED: 25078385] - PubMed
Staikou 2014 {published data only}
    1. Staikou C, Avramidou A, Ayiomamitis GD, Vrakas S, Argyra E. Effects of intravenous versus epidural lidocaine infusion on pain intensity and bowel function after major large bowel surgery: a double‐blind randomized controlled trial. Journal of Gastrointestinal Surgery 2014;18(12):2155‐62. [1873‐4626; PUBMED: 25245767] - PubMed
Striebel 1992 {published data only}
    1. Striebel HW, Klettke U. Is intravenous lidocaine infusion suitable for postoperative pain management?. Schmerz 1992;6(4):245‐50. [PUBMED: 18415635] - PubMed
Swenson 2010 {published data only}
    1. NCT00600158. Effects of intravenous local anesthetic on bowel function after colectomy. clinicaltrials.gov/ct2/show/NCT00600158 (first received 24 January 2008 ).
    1. Swenson BR, Gottschalk A, Wells LT, Rowlingson JC, Thompson PW, Barclay M, et al. Intravenous lidocaine is as effective as epidural bupivacaine in reducing ileus duration, hospital stay, and pain after open colon resection: a randomized clinical trial. Regional Anesthesia and Pain Medicine 2010;35(4):370‐6. [PUBMED: 20588151] - PubMed
Terkawi 2014 {published data only}
    1. NCT01204242. IV lidocaine for patients undergoing primary breast cancer surgery: effects on postoperative recovery and cancer recurrence. clinicaltrials.gov/show/NCT01204242 (first received 17 September 2010).
    1. Terkawi A, Durieux M, Gottschalk A, Brenin D, Tiouririne M. Effect of intravenous lidocaine on postoperative recovery of patients undergoing mastectomy: A double‐blind, placebo‐controlled randomized trial. Regional Anesthesia and Pain Medicine 2014;39(6):472‐7. [1098‐7339; PUBMED: 25275577] - PubMed
    1. Terkawi AS, Brenin D, Durieux ME, Blum FE, Tiouririne M. Effect of intravenous lidocaine on postoperative recovery in patients undergoing breast surgery: A double‐blinded, placebo randomized controlled trial. Anesthesia and Analgesia 2014;118((5 Suppl 1)):S208. [EMBASE: 71590951]
    1. Terkawi AS, Sharma S, Durieux ME, Thammishetti S, Brenin D, Tiouririne M. Perioperative lidocaine infusion reduces the incidence of post‐mastectomy chronic pain: a double‐blind, placebo‐controlled randomized trial. Pain Physician 2015;18(2):E139‐46. [2150‐1149; PUBMED: 25794212] - PubMed
Tikuisis 2014 {published data only}
    1. Tikuisis R, Miliauskas P, Samalavicius NE, Zurauskas A, Samalavicius R, Zabulis V. Intravenous lidocaine for post‐operative pain relief after hand‐assisted laparoscopic colon surgery: A randomized, placebo‐controlled clinical trial. Techniques in Coloproctology 2014;18(4):373‐80. [PUBMED: 24030782] - PMC - PubMed
Wallin 1987 {published data only}
    1. Wallin G, Cassuto J, Hogstrom S, Linden I, Faxen A, Rimback G, et al. Effects of lidocaine infusion on the sympathetic response to abdominal surgery. Anesthesia and Analgesia 1987;66(10):1008‐13. [PUBMED: 3631561] - PubMed
Wang 2002 {published data only}
    1. Wang D, Wu X, Li J, Xiao F, Liu X, Meng M. The effect of lidocaine on early postoperative cognitive dysfunction after coronary artery bypass surgery. Anesthesia and Analgesia 2002;95(5):1134‐41. [PUBMED: 12401580] - PubMed
Wang 2015 {published data only}
    1. Wang HL, Yan HD, Liu YY, Sun BZ, Huang R, Wang XS, et al. Intraoperative intravenous lidocaine exerts a protective effect on cell‐mediated immunity in patients undergoing radical hysterectomy. Molecular Medicine Reports 2015;12(5):7039‐44. [1791‐3004; PUBMED: 26299324] - PubMed
Weinberg 2016 {published data only}
    1. Anonymous. Correction. Erratum for: A randomised controlled trial of peri‐operative lidocaine infusions for open radical prostatectomy [Anaesthesia, 2016, 71, (405‐410), 10.1111/anae.13368]. Anaesthesia 2016;71(10):1249‐50. [0003‐2409; PUBMED: 27611054] - PMC - PubMed
    1. Weinberg L, Rachbuch C, Ting S, Howard W, Yeomans M, Gordon I, et al. A randomised controlled trial of peri‐operative lidocaine infusions for open radical prostatectomy. [Erratum appears in Anaesthesia. 2016;71(10):1249‐50; PMID: 27611054]. Anaesthesia 2016;71(4):405‐10. [1365‐2044; PUBMED: 26749026] - PMC - PubMed
Wongyingsinn 2011 {published data only}
    1. NCT01155440. Bowel function after laparoscopic colon surgery: effect of IV lidocaine. clinicaltrials.gov/ct2/show/NCT01155440 (first received 1 July 2010).
    1. Wongyingsinn M, Baldini G, Charlebois P, Liberman S, Stein B, Carli F. Intravenous lidocaine versus thoracic epidural analgesia: a randomized controlled trial in patients undergoing laparoscopic colorectal surgery using an enhanced recovery program. Regional Anesthesia and Pain Medicine 2011;36(3):241‐8. [PUBMED: 21519309] - PubMed
Wu 2005 {published data only}
    1. Wu CT, Borel CO, Lee MS, Yu JC, Liou HS, Yi HD, et al. The interaction effect of perioperative cotreatment with dextromethorphan and intravenous lidocaine on pain relief and recovery of bowel function after laparoscopic cholecystectomy. Anesthesia and Analgesia 2005;100(2):448‐53. [PUBMED: 15673874] - PubMed
Wuethrich 2012 {published data only}
    1. NCT00789620. Effects of intravenous lidocaine on transperitoneal laparoscopic urological surgery [Effects of intravenous lidocaine on transperitoneal laparoscopic urological surgery: a prospective, randomised, placebo controlled, double‐blind, phase III study]. clinicaltrials.gov/ct2/show/NCT00789620 (first received 13 November 2008).
    1. Wuethrich PY, Romero J, Burkhard FC, Curatolo M. No benefit from perioperative intravenous lidocaine in laparoscopic renal surgery: a randomised, placebo‐controlled study. European Journal of Anaesthesiology 2012;29(11):537‐43. [PUBMED: 22907609] - PubMed
Xu 2017 {published data only}
    1. Xu SQ, Li YH, Wang SB, Hu SH, Ju X, Xiao JB. Effects of intravenous lidocaine, dexmedetomidine and their combination on the postoperative pain and recovery of bowel function in patients undergoing abdominal hysterectomy. Minerva Anestesiologica 2017;83(7):685‐94. [1827‐1596; PUBMED: 28094477] - PubMed
Yang 2014 {published data only}
    1. Choi YS, Gang H. Intraperitoneal and intravenous lidocaine for pain relief after laparoscopic cholecystectomy: A prospective randomized double‐blind placebo‐controlled study. Surgical Endoscopy and Other Interventional Techniques. 2014; Vol. 28:265. [EMBASE: 71479921; 0930‐2794]
    1. Yang SY, Kang H, Choi GJ, Shin HY, Baek CW, Jung YH, et al. Efficacy of intraperitoneal and intravenous lidocaine on pain relief after laparoscopic cholecystectomy. Journal of International Medical Research 2014;42(2):307‐19. [PUBMED: 24648482] - PubMed
Yardeni 2009 {published data only}
    1. Yardeni IZ, Beilin B, Mayburd E, Levinson Y, Bessler H. The effect of perioperative intravenous lidocaine on postoperative pain and immune function. Anesthesia and Analgesia 2009;109(5):1464‐9. [PUBMED: 19843784] - PubMed
Yon 2014 {published data only}
    1. ACTRN12612000545864. The effect of intravenous lidocaine infusion on the pain after subtotal gastrectomy [In patients undergoing subtotal gastrectomy, is intravenous lidocaine infusion effective in reducing post‐operative pain?]. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=362535&isRe... (first received 22 May 2012).
    1. Yon JH, Choi GJ, Kang H, Park JM, Yang HS. Intraoperative systemic lidocaine for pre‐emptive analgesics in subtotal gastrectomy: a prospective, randomized, double‐blind, placebo‐controlled study. Canadian Journal of Surgery 2014;57(3):175‐82. [1488‐2310; PUBMED: 24869609] - PMC - PubMed
Zengin 2015 {published data only}
    1. Zengin SU, Saracoglu A, Eti Z, Umuroglu T, Gogus FY. The effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement in patients undergoing laparatomy. Pain Research and Management 2015;20(4):179‐82. [1918‐1523; PUBMED: 25950425] - PMC - PubMed

References to studies excluded from this review

Bartlett 1961 {published data only}
    1. Bartlett EE, Hutserani O. Xylocaine for the relief of postoperative pain. Anesthesia and Analgesia 1961;40:296‐304. [PUBMED: 14448503] - PubMed
Birch 1987 {published data only}
    1. Birch K, Jørgensen J, Chraemmer‐Jørgensen B, Kehlet H. Effect of i.v. lignocaine on pain and the endocrine metabolic responses after surgery. British Journal of Anesthesia 1987;59(6):721‐4. [PUBMED: 3606915] - PubMed
Cepeda 1996 {published data only}
    1. Cepeda MS, Delgado M, Ponce M, Cruz CA, Carr DB. Equivalent outcomes during postoperative patient‐controlled intravenous analgesia with lidocaine plus morphine versus morphine alone. Anesthesia and Analgesia 1996;83(1):102‐6. [PUBMED: 8659717] - PubMed
Chia 1998 {published data only}
    1. Chia YY, Tan PH, Wang KY, Liu K. Lignocaine plus morphine in bolus patient‐controlled intravenous analgesia lacks post‐operative morphine‐sparing effect. European Journal of Anaesthesiology 1998;15(6):664‐8. [PUBMED: 9884851] - PubMed
Couceiro 2015 {published data only}
    1. Couceiro TC, Lima LC, Burle LM, Valenca MM. Intravenous lidocaine for postmastectomy pain treatment: randomized, blind, placebo controlled clinical trial. Brazilian Journal of Anesthesiology 2015;65(3):207‐12. [PUBMED: 25925033 ] - PubMed
De Clive‐Lowe 1958 {published data only}
    1. Clive‐Lowe SG, Desmond J, North J. Intravenous lignocaine anaesthesia. Anaesthesia 1958;13(2):138‐46. [PUBMED: 13521304] - PubMed
De Kock 1994 {published data only}
    1. Kock M, Lavandhomme P, Scholtes JL. Intraoperative and postoperative analgesia using intravenous opioid, clonidine and lignocaine. Anaesthesia and Intensive Care 1994;22(1):15‐21. [PUBMED: 8160943] - PubMed
Feld 2003 {published data only}
    1. Feld JM, Laurito CE, Beckerman M, Vincent J, Hoffman WE. Non‐opioid analgesia improves pain relief and decreases sedation after gastric bypass surgery. General Anesthesia 2003;50(4):336‐41. [PUBMED: 12670809] - PubMed
Hans 2010 {published data only}
    1. Hans GA, Lauwick SM, Kaba A, Bonhomme V, Struys MM, Hans PC, et al. Intravenous lidocaine infusion reduces bispectral index‐guided requirements of propofol only during surgical stimulation. British Journal of Anaesthesia 2010;105(4):471‐9. [PUBMED: 20650919] - PubMed
Harvey 2009 {published data only}
    1. Harvey KP, Adair JD, Isho M, Robinson R. Can intravenous lidocaine decrease postsurgical ileus and shorten hospital stay in elective bowel surgery? A pilot study and literature review. American Journal of Surgery 2009;198(2):231‐6. [PUBMED: 19285304] - PubMed
Joppich 2010 {published data only}
    1. Joppich R. Thema: impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery ‐ a systemic review of randomized controlled trials. Perioperative Medizin 2010;2:209‐10. [EMBASE: 360114423]
Juarez‐Pichardo 2009 {published data only}
    1. Juarez‐Pichardo JS, Avila‐Lopez A, Serrano‐Herrera MA. Preventive postoperative analgesia with dexmetomidine iv compared to lidocaine iv in cholecystectomy. Revista Mexicana de Anestesiología 2009;32(2):81‐8. [EMBASE: 355200435]
Kavak 2014 {published data only}
    1. Kavak Akelma F, Ergil J, Ozkan D, Akinci M, Ozmen M, Gumus H. A comparison of the effects of intraoperative esmolol and lidocaine infusions on postoperative analgesia. Anestezi Dergisi 2014;22(1):25‐31. [EMBASE: 372676615]
Knight 1980 {published data only}
    1. Knight PR, Kroll DA, Nahrwold ML, Denlinger JK, Kirsh M, Welter LO, et al. Comparison of cardiovascular responses to anesthesia and operation when intravenous lidocaine or morphine sulfate is used as adjunct to diazepam‐nitrous oxide anesthesia for cardiac surgery. Anesthesia and Analgesia 1980;59(2):130‐9. [PUBMED: 7189333] - PubMed
Marret 2008 {published data only}
    1. Marret E, Rolin M, Beaussier M, Bonnet F. Meta‐analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. British Journal of Surgery 2008;95(11):1331‐8. [PUBMED: 18844267] - PubMed
McCarthy 2010 {published data only}
    1. McCarthy GC, Megalla SA, Habib AS. Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. Drugs 2010;70(9):1149‐63. [PUBMED: 20518581] - PubMed
Olivares 2012 {published data only}
    1. Olivares AC, Ahuactzin TR, Marquez IV. Preventive analgesia with lidocaine in intravenous infusion vs sulfate of magnesium for postoperative pain management. British Journal of Anesthesia 2012;108:ii258. [EMBASE: 70719377]
Perniola 2014 {published data only}
    1. Perniola A, Magnuson A, Axelsson K, Gupta A. Intraperitoneal local anesthetics have predominant local analgesic effect: a randomized, double‐blind study. Anesthesiology 2014;121(2):352‐61. [PUBMED: 24758776 ] - PubMed
Rinne 1998 {published data only}
    1. Rinne T, Kaukinen S. Does lidocaine protect the heart during coronary revascularisation?. Acta Anaesthesiologica Scandinavica 1998;42(8):936‐40. [PUBMED: 9773138] - PubMed
Sun 2012 {published data only}
    1. Sun Y, Li T, Wang N, Yun Y, Gan TJ. Perioperative systemic lidocaine for postoperative analgesia and recovery after abdominal surgery: a meta‐analysis of randomized controlled trials. Diseases of the Colon and Rectum 2012;55(11):1183‐94. [PUBMED: 23044681] - PubMed
Vigneault 2011 {published data only}
    1. Vigneault L, Turgeon AF, Cote D, Lauzier F, Zarychanski R, Moore L, et al. Perioperative intravenous lidocaine infusion for postoperative pain control: A meta‐analysis of randomized controlled trials. Canadian Journal of Anesthesia 2011;58(1):22‐37. [PUBMED: 21061107] - PubMed
Zhu 2015 {published data only}
    1. Zhu M, Li Y, Wan Z, Zhang D, Wang X. Effects of small‐dose lidocaine combined with ketamine on early postoperative cognitive function in elderly patients undergoing gastrointestinal tumor surgery. Nan Fang Yi Ke Da Xue Xue Bao = Journal of Southern Medical University 2015;35(7):1076‐8, 1 p following 1078. [1673‐4254; PUBMED: 26198966] - PubMed

References to studies awaiting assessment

Cho 2014 {published data only}
    1. Cho K, Lee W, Lee JH, Kim MH, Lee KM. Perioperative infusion of lidocaine vs. dexmedetomidine; effect on reduction of postoperative analgesics consumption after laparoscopic cholecystectomy. European Journal of Anaesthesiology 2014;31:228. [0265‐0215]
Choi 2017 {published data only}
    1. Choi K, Nam K, Lee J, Chung W, Kang S, Joe Y, et al. The effects of intravenous lidocaine infusions on the quality of recovery and chronic pain after robotic thyroidectomy: a randomized, double‐blinded, controlled study. World Journal of Surgery 2017;41:1305‐12. [PUBMED: 27896411] - PubMed
Dewinter 2017 {published data only}
    1. Dewinter G, Moens P, Fieuws S, Vanaudenaerde B, Velde M, Rex S. Systemic lidocaine fails to improve postoperative morphine consumption, postoperative recovery and quality of life in patients undergoing posterior spinal arthrodesis. A double‐blind, randomized, placebo‐controlled trial. British Journal of Anaesthesia 2017;118:576‐85. [PUBMED: 28403408] - PubMed
Horvat 2014 {published data only}
    1. Horvat M, Sotosek Tokamdzic V, Dvornik S, Frkovic V, Azman J, et al. Perioperative intravenous lidocaine effects on postoperative pain and cytokine production in patients undergoing nephrectomy‐a pilot study. Regional Anesthesia and Pain Medicine 2014;1:e223‐4. [1098‐7339]
Jendoubi 2017 {published data only}
    1. Jendoubi A, Ben Naceur I, Marzougui Y, Kouka J, Ghedira S, Houissa M. A comparison of lidocaine and ketamine in acute and chronic pain after open nephrectomy: a prospective, double‐blind, randomized, placebo controlled study. Regional Anesthesia and Pain Medicine 2015;1:e80‐1. [1098‐7339]
    1. Jendoubi A, Naceur IB, Bouzouita A, Trifa M, Ghedira S, Chebil M, et al. A comparison between intravenous lidocaine and ketamine on acute and chronic pain after open nephrectomy: a prospective, double‐blind, randomized, placebo‐controlled study. Saudi Journal of Anaesthesia 2017;11:177‐84. [PUBMED: 28442956] - PMC - PubMed
Kendall 2017 {published data only}
    1. Kendall MC, McCarthy RJ, Panaro S, Goodwin E, Bialek JM, Nader A, et al. The effect of intraoperative systemic lldocaine on postoperative persistent pain using initiative on methods, measurement, and pain assessment in clinical trials criteria assessment following breast cancer surgery: a randomized, double‐blind, placebo‐controlled trial. Pain Practice 2017;10:10. [PUBMED: 28691269] - PubMed
Khalili 2017a {published data only}
    1. Khalili G, Attari MA, Rahnama H. Comparative study of the effects of pre‐emptive use of intravenous lidocaine and intramuscular piroxicam on muscular pain after lower abdominal surgery under the general anesthesia. Journal of Isfahan Medical School 2017;34:1481‐6. [614786865]
Khalili 2017b {published data only}
    1. Khalili G, Sadeghifar M, Attari MA. Evaluation of the effect of intravenous and intraperitoneal lidocaine on pain intensity in comparison to control group in laparoscopic cholecystectomy. Journal of Isfahan Medical School 2017;35:927‐33. [618692163]
Kim 2017 {published data only}
    1. Kim M, Lee K, Park S, Kim S, Park H, Yoo Y. Effects of systemic lidocaine versus magnesium administration on postoperative functional recovery and chronic pain in patients undergoing breast cancer surgery: a prospective, randomized, double‐blind, comparative clinical trial. PLOS ONE 2017;12(3):e0173026. [PUBMED: 28253307] - PMC - PubMed
Kim 2018 {published data only}
    1. Kim MH, Kim MS, Lee JH, Kim ST, Lee JR. Intravenously administered lidocaine and magnesium during thyroid surgery in female patients for better quality of recovery after anesthesia. Anesthesia and Analgesia 2018 Jan 09 [Epub ahead of print]. [PUBMED: 29324495] - PubMed
Lee 2017 {published data only}
    1. Lee U, Choi YJ, Choi GJ, Kang H. Intravenous lidocaine for effective pain relief after bimaxillary surgery. Clinical Oral Investigations 2017;21:2645‐52. [PUBMED: 28168381] - PubMed
Metha 2017 {published data only}
    1. Metha M, Trivedi B, Sharma K. A prospective randomised placebo controlled study to analyze effects of constant rate intravenous infusion of lignocaine on peri‐operative analgesia verses similar rate normal saline infusion. Regional Anesthesia and Pain Medicine. Forty‐Second Annual Regional Anesthesiology and Acute Pain Medicine Meeting, ASRA; 2017 April 6‐8; San Francisco (CA). 2017. [619776930]
NCT02257346 {published data only}
    1. NCT02257346. Intravenous lidocaine and quality of recovery after cesarean delivery [The effect of perioperative systemic lidocaine on quality of recovery after cesarean delivery]. clinicaltrials.gov/show/NCT02257346 (first received 6 October 2014).
Rahaymeh 2016 {published data only}
    1. Rahaymeh J, Alkhalaileh M, Meqbel A, Almajali B, Dabas RA. Effect of preoperative lidocaine infusion on postoperative morphine requirements in major laparotomy surgery. Rawal Medical Journal 2016;41(3):312‐5. [0303‐5212]
Sherif 2017 {published data only}
    1. Sherif A. The impact of continuous infusion adjutants on the quality of recovery after laproscopic barbaric surgery: dexmedetomidine versus lidocaine: a double‐blinded, randomized, placebo‐controlled trial. Regional Anesthesia and Pain Medicine 2016;41((5 Suppl 1)):e95. [1532‐8651]
    1. Sherif AA, Elsersy HE. The impact of dexmedetomidine or xylocaine continuous infusion on opioid consumption and recovery after laparoscopic sleeve gastrectomy. Minerva Anestesiologica 2017;83:1274‐82. - PubMed
Song 2017 {published data only}
    1. Song X, Sun Y, Zhang X, Li T, Yang B. Effect of perioperative intravenous lidocaine infusion on postoperative recovery following laparoscopic cholecystectomy ‐ a randomized controlled trial. International Journal of Surgery 2017;45:8‐13. [PUBMED: 28705592] - PubMed
Van Den Heuvel 2016 {published data only}
    1. Heuvel S, Berkum B, Markerink H, Wal S, Ronday M, Plat J, et al. Intravenous lidocaine reduces perioperative opioid administration and postoperative TNF‐a during oncologic breast surgery. Pain Practice. 2016; Vol. 16:134. [1533‐2500]
Yoo 2016 {published data only}
    1. Kim MH, Lee KY, Yoo YC, Kim YH, Min NH. Effects of systemic lidocaine versus magnesium administration on postoperative functional recovery and chronic pain in patients. Anesthesiology. 2016:A2190. - PMC - PubMed
    1. Yoo YC, Kang HJ. Effects of systemic lidocaine versus magnesium administration on postoperative functional recovery and chronic pain in patients undergoing breast cancer surgery: a randomized double‐blind clinical trial. Anesthesia and Analgesia 2016;123((3 Suppl 2)):484‐5. [1526‐7598] - PMC - PubMed

References to ongoing studies

NCT02059902 {published data only}
    1. NCT02059902. Continuous lidocaine infusion for management of perioperative burn pain. clinicaltrials.gov/show/NCT02059902 (first received 11 February 2014).
NCT02607488 {published data only}
    1. NCT02607488. Perioperative systemic lidocaine for enhanced bowel recovery after bariatric surgery [Perioperative systemic lidocaine for enhanced bowel recovery after bariatric surgery: a dose dependent study]. clinicaltrials.gov/show/NCT02607488 (first received 18 November 2015).
NCT02862769 {published data only}
    1. NCT02862769. Intra‐operative lidocaine infusion in preventing CPSP Post VATs [The role of Intra‐operative lidocaine infusion in preventing chronic post surgical pain after video assisted thoracoscopic surgery]. clinicaltrials.gov/show/NCT02862769 (first received 11 August 2016).

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