Department of Anesthesiology, Tianjin First Center Hospital, Tianjin, 300192, China.
Department of Anesthesiology, Tianjin First Center Hospital, Tianjin, 300192, China.
Int J Surg. 2018 Feb;50:137-145. doi: 10.1016/j.ijsu.2018.01.001. Epub 2018 Jan 10.
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.
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.
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.
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.
目前尚不清楚静脉注射利多卡因是否对腹腔镜胆囊切除术(LC)后急性疼痛的控制有有益作用。我们进行了一项荟萃分析,以确定静脉注射利多卡因治疗 LC 后急性术后疼痛的疗效和安全性。
2017 年 11 月,在 PubMed、EMBASE、Web of Science、ScienceDirect 和 Cochrane Library 中进行了系统搜索。检索了比较利多卡因和安慰剂在接受 LC 治疗的患者中的 RCT。主要终点是视觉模拟评分(VAS)和 12 小时、24 小时和 48 小时的阿片类药物需求。次要终点是住院时间和阿片类药物相关不良反应。使用 Stata 12.0 进行数据分析。
最终,有 6 项 RCT 纳入荟萃分析。结果表明,静脉注射利多卡因与 LC 后 12 小时、24 小时和 48 小时的疼痛评分和累积阿片类药物消耗降低有关。同样,利多卡因与恶心和呕吐、肠梗阻和瘙痒的发生率降低有关。
静脉使用利多卡因能够减轻 LC 后急性术后疼痛、总阿片类药物需求和阿片类药物相关不良反应。需要进一步的研究来确定利多卡因是否对改善 LC 后的术后功能有积极作用。