Systemic Lidocaine Shortens Length of Hospital Stay After Colorectal Surgery

Herroeder, Susanne; Pecher, Sabine; Schonherr, Marianne E.; Kaulitz, Grit; Hahnenkamp, Klaus; Friess, Helmut; Böttiger, Bernd W.; Bauer, Harry; Dijkgraaf, Marcel G. W.; Durieux, Marcel E.; Hollmann, Markus W.

doi:10.1097/sla.0b013e31805dac11

Cited by 314 publications

(246 citation statements)

References 36 publications

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“…31,35 A comparable length of stay was observed in the IVLI groups and control groups in both studies. Pooled results of hospital length of stay from nine studies showed a statistically significant reduction of about four hours for patients who received IVLI (nine studies, n = 539, WMD -0.17 day, 95% CI -0.41 to 0.07; I 2 = 8%).…”

Section: Length Of Staymentioning

confidence: 51%

“…24 Seven studies originated in the USA, [25][26][27][28][29][30][31] one in Belgium, 32 two in Taiwan, 14,33 three in Germany, 23,34,35 one in New Zealand, 36 three in Sweden, [37][38][39] two in China, 40,41 one in France, 42 three in Canada, [43][44][45] one in Mexico, 24 two in Saudi Arabia, 46,47 one in Israel, 48 one in the Republic of Korea 49 and one in Finland. 50 Studies were conducted in patients undergoing abdominal, cardiac, thoracic, orthopedic, or urologic surgery ( Table 1).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…51 Twenty-six (90%) studies were placebo-controlled blinded studies. 14,[23][24][25][26][27][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][45][46][47][48][49] Primary outcomes…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…Laparoscopic colectomy 57 ± 17 Lidocaine infusion for postoperative analgesia 27 scores, 14,24,26,[31][32][33]35,38,40,42,45,47,48 while five studies presented median pain score. 23,25,34,43,44 The data from the studies reporting medians could not be included in the pooled analyses.…”

Section: Postoperative Painmentioning

confidence: 99%

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Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials

Vigneault

Turgeon

Côté

et al. 2010

Can J Anesth/J Can Anesth

333

227

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Introduction Various strategies have been proposed for postoperative pain control. Among those, intravenous lidocaine infusion (IVLI) has gained in interest. However, its clinical benefit remains unclear. This systematic review is an evaluation of the analgesic efficacy and safety of IVLI during general anesthesia. Methods A systematic search was performed using MED-LINE, EMBASE, Cochrane, and SCOPUS databases, likewise, grey literature. The review included all randomized controlled trials that used a placebo or any comparator and evaluated IVLI during general anesthesia for any type of surgery. Primary outcomes were pain control and opioid requirement. Secondary outcomes were mortality, length of stay, ileus recovery time, nausea/vomiting, and adverse events. Random effects models were used and heterogeneity was assessed using the I 2 index. to -5.56), time to first flatus (WMD -7.62 hr, 95% CI -10.78 to -4.45), time to first feces (WMD -10.71 hr, 95% CI -16.14 to -5.28), nausea/vomiting (risk ratios = 0.71, 95% CI 0.57-0.90), and hospital length of stay (WMD -0.17 days, 95% CI -0.41 to 0.07). Abdominal surgery was strongly associated with benefit. For the 12 studies that systematically screened adverse events, the Results 123Can J Anesth/J Can Anesth (2011) 58:22-37 DOI 10.1007/s12630-010-9407-0 incidence of cardiac and neurologic adverse events was comparable. Eight studies observed toxic plasma levels. Discussion Perioperative IVLI reduced postoperative pain and opioid requirement, as well as ileus recovery time, hospital length of stay, and nausea/vomiting. Intravenous lidocaine infusion was effective mainly in abdominal surgery populations. Considering that toxic levels were detected and that adverse events were not systematically screened for in most studies, dose and safety of IVLI should be established before recommending its use. RésuméIntroduction Plusieurs strate´gies ont e´te´propose´es pour le contrôle de la douleur postope´ratoire. Parmi ces strate´gies, la lidocaı¨ne par voie intraveineuse suscite un inte´reˆt croissant. Toutefois, ses avantages cliniques demeurent peu clairs. Cette revue me´thodique est une e´valuation de l'efficaciteá nalge´sique et de l'innocuite´de la lidocaı¨ne par voie intraveineuse pendant l'anesthe´sie ge´ne´rale. Méthode Une recherche me´thodique a e´te´re´alise´e dans les bases de donne´es MEDLINE, EMBASE, Cochrane et SCOPUS ainsi que dans la litte´rature grise. Cette revue a tenu compte de toutes les e´tudes randomise´es contrôle´es ayant utilise´un placebo ou un traitement de re´fe´rence et e´value´la lidocaı¨ne par voie intraveineuse pendant l'anesthe´sie ge´ne´rale, quel que soit le type de chirurgie. Les principaux crite`res d'e´valuation e´taient le contrôle de la douleur et le besoin en opioı¨des. Les crite`res d'e´valuation secondaires e´taient la mortalite´, la dure´e d'hospitalisation, le temps de re´cupe´ration du transit intestinal, les nause´es et vomissements et les e´ve´nements inde´sirables. Des mode`les a`effets ale´atoires ont e´teú tilise´s e...

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Section: Length Of Staymentioning

confidence: 51%

Section: Description Of Included Studiesmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Postoperative Painmentioning

confidence: 99%

See 2 more Smart Citations

Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials

Vigneault

Turgeon

Côté

et al. 2010

Can J Anesth/J Can Anesth

333

227

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“…IV lidocaine also depresses spike activity, amplitude and conduction time in both myelinated A and unmyelinated C fibres [5,27]. Lidocaine anti-inflammatory activity may be another potential mechanism in improving perioperative pain by reducing cytokines release and neutrophil activation [8]. It reduces spinal cord neurons activity and decreases postsynaptic depolarization mediated by N-methyl-D-aspartate (NMDA) [5].…”

Section: Discussionmentioning

confidence: 99%

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Nakhli

Kahloul

Guizani

et al. 2018

Libyan Journal of Medicine

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The role of intraoperative intravenous lidocaine infusion has been previously evaluated for pain relief, inflammatory response, and post-operative recovery, particularly in abdominal surgery. The present study is a randomized double-blinded trial in which we evaluated whether IV lidocaine infusion reduces isoflurane requirement, intraoperative remifentanil consumption and time to post-operative recovery in non-laparoscopic renal surgery. Sixty patients scheduled to undergo elective non-laparoscopic renal surgery under general anesthesia were enrolled to receive either systemic lidocaine infusion (group L: bolus 1.5 mg/kg followed by a continuous infusion at the rate of 2 mg/kg/hr until skin closure) or normal saline (0.9% NaCl solution) (Group C). The depth of anesthesia was monitored using the Bispectral Index Scale (BIS), which is based on measurement of the patient’s cerebral electrical activity. Primary outcome of the study was End-tidal of isoflurane concentration (Et-Iso) at BIS values of 40–60. Secondary outcomes include remifentanil consumption during the operation and time to extubation. Et-Iso was significantly lower in group L than in group C (0.63% ± 0.10% vs 0.92% ± 0.11%, p < 10–3). Mean remifentanil consumption of was significantly lower in group L than in group C (0.13 ± 0.04 µg/kg/min vs 0.18 ± 0.04 µg/kg/min, p < 10–3). Thus, IV lidocaine infusion permits a reduction of 31% in isoflurane concentration requirement and 27% in the intraoperative remifentanil need. In addition, recovery from anesthesia and extubation time was shorter in group L (5.8 ± 1.8 min vs 7.9 ± 2.0 min, p < 10–3). By reducing significantly isoflurane and remifentanil requirements during renal surgery, intravenous lidocaine could provide effective strategy to limit volatile agent and intraoperative opioids consumption especially in low and middle income countries.

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Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery

Andreae

2012

Cochrane Database of Systematic Reviews

102

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Background Regional anaesthesia may reduce the rate of persistent (chronic) pain after surgery, a frequent and debilitating condition. Objectives To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of persistent pain six or 12 months after surgery. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 4), PubMed (1966 to April 2012), EMBASE (1966 to May 2012) and CINAHL (1966 to May 2012) without any language restriction. We used a combination of free text search and controlled vocabulary search. The results were limited to randomized controlled clinical trials (RCTs). We conducted a handsearch in reference lists of included trials, review articles and conference abstracts. Selection criteria We included RCTs comparing local anaesthetics or regional anaesthesia versus conventional analgesia with a pain outcome at six or 12 months after surgery. Data collection and analysis Two authors independently assessed trial quality and extracted data, including information on adverse events. We contacted study authors for additional information. Results are presented as pooled odds ratios (OR) with 95% confidence intervals (CI), based on random-effects models (inverse variance method). We grouped studies according to surgical interventions. We employed the Chi2 test and calculated the I2 statistic to investigate study heterogeneity. Main results We identified 23 RCTs studying local anaesthetics or regional anaesthesia for the prevention of persistent (chronic) pain after surgery. Data from a total of 1090 patients with outcomes at six months and of 441 patients with outcomes at 12 months were presented. No study included children. We pooled data from 250 participants after thoracotomy, with outcomes at six months. Data favoured regional anaesthesia for the prevention of chronic pain at six months after thoracotomy with an OR of 0.33 (95% CI 0.20 to 0.56). We pooled two studies on paravertebral block for breast cancer surgery; the pooled data of 89 participants with outcomes at five to six months favoured paravertebral block with an OR of 0.37 (95% CI 0.14 to 0.94).The methodological quality of the included studies was intermediate. Adverse effects were not studied systematically and were reported sparsely. Clinical heterogeneity, attrition and sparse outcome data hampered the assessment of effects, especially at 12 months. Authors’ conclusions Epidural anaesthesia may reduce the risk of developing chronic pain after thoracotomy in about one patient out of every four patients treated. Paravertebral block may reduce the risk of chronic pain after breast cancer surgery in about one out of every five women treated. Our conclusions are significantly weakened by performance bias, shortcomings in allocation concealment, considerable attrition and incomplete outcome data. We caution that our evidence synthesis is based on only a few, small studies. More studies with high methodological quality, addre...

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Systemic Lidocaine Shortens Length of Hospital Stay After Colorectal Surgery

Cited by 314 publications

References 36 publications

Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials

Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials

Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery

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