Effectiveness of intravenous lidocaine in preventing postoperative nausea and vomiting in pediatric patients: A systematic review and meta-analysis

Abstract

Background Intravenous lidocaine in adults undergoing general anesthesia has been shown to reduce the incidence of postoperative nausea and vomiting (PONV). However, the anti-postoperative vomiting (POV) effect of lidocaine in pediatric patients remains unclear. We conducted a systematic review and meta-analysis with Trial Sequential Analysis to evaluate the effect of intravenous lidocaine on prevention of POV/PONV. Methods Six databases including trial registration sites were searched. Randomized clinical trials evaluating the incidence of POV/PONV after intravenous lidocaine compared with control were included. The primary outcome was the incidence of POV within 24 hours after general anesthesia. The incidence of POV was combined as a risk ratio with 95% confidence interval using a random-effect model. We used the I 2 to assess heterogeneity. We evaluated the quality of trials using the Cochrane methodology, and we assessed quality of evidence using the Grading of Recommendation Assessment, Development, and Evaluation approach. We also assessed adverse events. Results and discussion Six trials with 849 patients were included, of whom 433 received intravenous lidocaine. Three trials evaluated the incidence of POV, and 3 evaluated the incidence of PONV. The overall incidence of POV within 24 hours after anesthesia was 45.9% in the lidocaine group and 63.4% in the control group (risk ratio, 0.73; 95% confidence interval, 0.53-1.00; I 2 = 32%; p = 0.05). The incidence of PONV within 24 hours after anesthesia was 3.73% in the lidocaine group and 4.87% in the control group (RR, 0.76; 95% CI, 0.36-1.59; I 2 = 0%; p =

Appraising and highlighting gaps among prophylactic intervention studies for reducing the incidence of postoperative nausea and vomiting in children: a systematic review

“…The 20 studies were published across a 15-year period (1995–2020) and from 10 different countries: the USA (n=6),12 21 22 25 28 29 Taiwan (n=3),11 13 20 Australia (n=2),14 24 China (n=2),15 27 Germany (n=2),18 19 Belgium (n=1),30 Japan (n=1),16 Brazil (n=1),17 the UK (n=1)23 and India (n=1)26 (tables 1 and 2). Out of 20 eligible studies, only 7 studies included information about funding sources 11 16 18 19 23 24 29. The number of RCTs included in each review ranged between 4 and 50 and the total number of participants ranged from 493 to 6437.…”

“…Fourteen of the included reviews primarily investigated pharmacological PONV prophylaxis in paediatric populations (figure 2). 11–23 30 A further five studies focused on non-pharmacological PONV prophylaxis, such as acustimulation (acupuncture, acupressure, laser acupuncture, electrical stimulation (ETS)),25 27–29 and laryngeal mask airway (LMA) compared with endotracheal tube (ETT) 26. The final eligible review was a mixed study of both pharmacological and non-pharmacological prophylactic interventions 24…”

Continuous infusion of lidocaine in pediatric colonoscopy

“…[ 22 23 24 ] Pediatric use of lidocaine has mainly concentrated on perioperative analgesia and preventing postoperative nausea and vomiting. [ 20 25 26 ]…”

Intravenous Infusion of Lidocaine Can Accelerate Postoperative Early Recovery in Patients Undergoing Surgery for Obstructive Sleep Apnea

“…Besides improving analgesia, perioperative infusion of lidocaine decreases the incidence of PONV [ 12 , 28 , 35 , 39 , 46 , 48 , 50 ]. This effect has been attributed to an increase in intestinal motility and/or a reduction in postoperative pain and opioid use.…”