Durket Elyse, Gillen Alexandra, Kottwitz Jack, Munsterman Amelia
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa.
Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, Alabama.
Vet Surg. 2020 Jan;49(1):44-52. doi: 10.1111/vsu.13286. Epub 2019 Jul 9.
To determine the efficacy of lidocaine at reducing incidence of postoperative reflux (POR) in horses by using quantitative statistical analysis.
Systematic meta-analytical review.
Studies on horses undergoing gastrointestinal surgery for small intestinal lesions, identified by systematic search between 2001 and 2017.
A search with PubMed/MEDLINE, Web of Science, and Google Scholar was performed, followed by secondary searches of veterinary trade journals and bibliographies of relevant articles. The primary outcome measure for this study was the effect of lidocaine therapy on the odds of POR. Subgroup analysis assessed included the timing of lidocaine therapy, incidence of mortality, and incidence of repeat celiotomy. A meta-analysis was performed with a random effects model, with the effect size calculated as an odds ratio (OR) with 95% confidence intervals (CI). Statistical significance was set at P < .05.
Among 1933 peer reviewed publications that met the initial search criteria, 12 relevant studies were available for analysis. Lidocaine was associated with an increased incidence of diagnosis of POR (OR 6.3, 95% CI [1.4, 27.0], P = .01). Horses treated with lidocaine were more likely to survive to discharge (OR 6.8, 95% CI [3.9, 11.7], P < .01).
Lidocaine was associated with an increased survival rate in horses undergoing exploratory celiotomy for small intestinal disease according to this meta-analysis of the recent literature.
This body of published evidence provides support to administer lidocaine in horses to improve survival rather than preventing POR.
通过定量统计分析确定利多卡因降低马术后反流（POR）发生率的疗效。
系统的荟萃分析综述。
对2001年至2017年间通过系统检索确定的接受小肠病变胃肠手术的马进行研究。
在PubMed/MEDLINE、科学网和谷歌学术上进行检索，随后对兽医行业期刊和相关文章的参考文献进行二次检索。本研究的主要结局指标是利多卡因治疗对POR几率的影响。评估的亚组分析包括利多卡因治疗的时间、死亡率和再次开腹手术的发生率。采用随机效应模型进行荟萃分析，效应大小计算为比值比（OR），并给出95%置信区间（CI）。设定统计学显著性为P < 0.05。
在符合初始检索标准的1933篇同行评审出版物中，有12项相关研究可供分析。利多卡因与POR诊断发生率增加相关（OR 6.3，95% CI [1.4, 27.0]，P = 0.01）。接受利多卡因治疗的马更有可能存活至出院（OR 6.8，95% CI [3.9, 11.7]，P < 0.01）。
根据对近期文献的这项荟萃分析，利多卡因与接受小肠疾病探查性开腹手术的马的存活率增加相关。
这一已发表的证据支持在马中使用利多卡因以提高存活率，而非预防POR。
