Quadratus Lumborum Block Versus Perioperative Intravenous Lidocaine for Postoperative Pain Control in Patients Undergoing Laparoscopic Colorectal Surgery

Dewinter, Geertrui; Coppens, Steve; Velde, Marc Van de; D’Hoore, André; Wolthuis, Albert; Cuypers, Eva; Rex, Steffen

doi:10.1097/sla.0000000000002888

Cited by 64 publications

(80 citation statements)

References 45 publications

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“…After reviewing the full text, 15 additional irrelevant trials were excluded. Finally, the articles considered to be suitable for this meta‐analysis consisted of 10 RCTs, enrolling a total of 527 adult patients. The search process is shown in Figure .…”

Section: Resultsmentioning

confidence: 99%

“…Of the 10 studies, 2 studies were from Belgium; 2 studies were from Korea; 2 studies were from China; and the each of the remaining 4 studies were from France, Egypt, Lithuania, and Slovenia. All studies received IV lidocaine infusion before skin incision; five studies received IV lidocaine for more than 24 hours after surgery, and the other five studies infused lidocaine less than 24 hours after surgery. Most of the loading dose of lidocaine was 1.0 to 2.0 mg/kg, and continuous dose was 1.0 to 2.0 mg/kg/h.…”

Section: Resultsmentioning

confidence: 99%

“…There existed significant heterogeneity in the study by Dewinter et al compared with other studies. This study aimed to compare the analgesic efficacy of systemic lidocaine with the quadratus lumborum (QL) block in laparoscopic colorectal surgery.…”

Section: Discussionmentioning

confidence: 95%

“…This may have blunted any additional effect that the lidocaine infusion may have had and explains how it was possible for the placebo group to have lower post‐op opioid consumption. Another reason might be the limited sample size that may have underpowered this trial …”

Section: Discussionmentioning

confidence: 99%

“…A previous study by MacFater et al included open and laparoscopic colorectal operations, and they did not perform meta‐analysis because of heterogeneity in studies. Second, a recent meta‐analysis by Cooke et al included nine RCTs with 405 patients undergoing colorectal surgery and included only four laparoscopic colorectal surgery studies, but we added another six studies to our meta‐analysis. Third, compared with previous studies, our study added other indicators: pain scores at rest and on movement at five different time points and CRP because pain scores at different time points are important for pain assessment, and CRP is usually a landmark for the severity of inflammation.…”

Section: Discussionmentioning

confidence: 99%

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The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

Shi

Zhang

Wei‐wei

et al. 2019

International Wound Journal

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To evaluate the efficacy of intravenous lidocaine in relieving postoperative pain and promoting rehabilitation in laparoscopic colorectal surgery, we conducted this meta‐analysis. The systematic search strategy was performed on PubMed, EMBASE, Chinese databases, and Cochrane Library before September 2019. As a result, 10 randomised clinical trials were included in this meta‐analysis (n = 527 patients). Intravenous lidocaine significantly reduced pain scores at 2, 4, 12, 24, and 48 hours on movement and 2, 4, and 12 hours on resting‐state and reduced opioid requirement in first 24 hours postoperatively (weighted mean difference [WMD] = −5.02 [−9.34, −0.70]; P = .02). It also decreased the first flatus time (WMD: −10.15 [−11.20, −9.10]; P < .00001), first defecation time (WMD: −10.27 [−17.62, −2.92]; P = .006), length of hospital stay (WMD: −1.05 [−1.89, −0.21]; P = .01), and reduced the incidence of postoperative nausea and vomiting (risk ratio: 0.53 [0.30, 0.93]; P = .03) when compared with control group. However, it had no effect on pain scores at 24 and 48 hours at rest, the normal dietary time, and the level of serum C‐reactive protein. In summary, perioperative intravenous lidocaine could alleviate acute pain, reduce postoperative analgesic requirements, and accelerate recovery of gastrointestinal function in patients undergoing laparoscopic colorectal surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

Shi

Zhang

Wei‐wei

et al. 2019

International Wound Journal

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Male gender, smoking, younger age, and preoperative pain found to increase postoperative opioid requirements in 592 elective colorectal resections

Karlsdottir

Wahba

et al. 2022

Int J Colorectal Dis

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With increased awareness of the opioid epidemic, understanding contributing factors to postoperative opioid use is important. The purpose of this study was to evaluate patient and perioperative factors that contribute to postoperative opioid use after colorectal resections and their relation to pre-existing pain conditions and psychiatric diagnoses. MethodsA retrospective review was conducted identifying adult patients who underwent elective colorectal resection at a single tertiary center between 2015 and 2018. Patient demographics, preoperative factors, surgical approach, and perioperative pain management were evaluated to determine standard conversion morphine milligram equivalents required for postoperative days 0 to 3 and total hospital stay. ResultsFive hundred and ninety-two patients: 46% male, median age 58 years undergoing colorectal resections for indications including cancer, in ammatory bowel disease, and diverticulitis were identi ed. Less opioid use was found to be associated with female gender (β = -42), patients who received perioperative lidocaine infusion (β = -30), and older adults (equivalents/year) (β = -4, all p < 0.01). Preoperative opioid use, preoperative abdominal pain, epidural use and smoking were all independently associated with increased postoperative opioid requirements. ConclusionsIn this study of patients undergoing elective colorectal resection, factors that were associated with higher perioperative opioid use included male gender, smoking, younger age, preoperative opioid use, preoperative abdominal pain, and epidural use. Perioperative administration of lidocaine was associated with decreased opioid requirements. Understanding risk factors and stratifying postoperative pain regimens may aid in improved pain control and decrease long-term dependency.

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Effects of quadratus lumborum block regional anesthesia on postoperative pain after colorectal resection: a randomized controlled trial

et al. 2019

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Quadratus Lumborum Block Versus Perioperative Intravenous Lidocaine for Postoperative Pain Control in Patients Undergoing Laparoscopic Colorectal Surgery

Abstract: Eudra CT: 2014-001499-73; 31/7/2014.

Cited by 64 publications

References 45 publications

The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

Male gender, smoking, younger age, and preoperative pain found to increase postoperative opioid requirements in 592 elective colorectal resections

Effects of quadratus lumborum block regional anesthesia on postoperative pain after colorectal resection: a randomized controlled trial

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