Bi Yaodan, Ye Yu, Ma Jun, Tian Zerong, Zhang Xiuqian, Liu Bin
Department of Anesthesiology.
Department of Neurosurgery.
Medicine (Baltimore). 2020 Nov 25;99(48):e23332. doi: 10.1097/MD.0000000000023332.
Perioperative intravenous lidocaine has been reported to have analgesic and opioid-sparing effects in many kinds of surgery. Several studies have evaluated its use in the settings of spine surgery. The aim of the study is to examine the effect of intravenous lidocaine in patients undergoing spine surgery.
We performed a quantitative systematic review. Databases of PubMed, Medline, Embase database and Cochrane library were investigated for eligible literatures from their establishments to June, 2019. Articles of randomized controlled trials that compared intravenous lidocaine to a control group in patients undergoing spine surgery were included. The primary outcome was postoperative pain intensity. Secondary outcomes included postoperative opioid consumption and the length of hospital stay.
Four randomized controlled trials with 275 patients were included in the study. postoperative pain compared with control was reduced at 6 hours after surgery (WMD -0.50, 95%CI, -0.76 to -0.25, P < .001), at 24 hours after surgery (WMD -0.50, 95%CI, -0.70 to -0.29, P < .001) and at 48 hours after surgery (WMD -0.57, 95%CI, -0.96 to -0.17, P = .005). The effect of intravenous lidocaine on postoperative opioid consumption compared with control revealed a significant effect (WMD -15.36, 95%CI, -21.40 to -9.33 mg intravenous morphine equivalents, P < .001).
This quantitative analysis of randomized controlled trials demonstrated that the perioperative intravenous lidocaine was effective for reducing postoperative opioid consumption and pain in patients undergoing spine surgery. The intravenous lidocaine should be considered as an effective adjunct to improve analgesic outcomes in patients undergoing spine surgery. However, the quantity of the studies was very low, more research is needed.
围手术期静脉注射利多卡因已被报道在多种手术中具有镇痛和节省阿片类药物的作用。多项研究评估了其在脊柱手术中的应用。本研究的目的是探讨静脉注射利多卡因对脊柱手术患者的影响。
我们进行了一项定量系统评价。检索了PubMed、Medline、Embase数据库和Cochrane图书馆，从建库至2019年6月查找符合条件的文献。纳入比较脊柱手术患者静脉注射利多卡因与对照组的随机对照试验文章。主要结局是术后疼痛强度。次要结局包括术后阿片类药物消耗量和住院时间。
本研究纳入了4项随机对照试验，共275例患者。与对照组相比，术后6小时（加权均数差-0.50，95%可信区间，-0.76至-0.25，P<0.001）、术后24小时（加权均数差-0.50，95%可信区间，-0.70至-0.29，P<0.001）和术后48小时（加权均数差-0.57，95%可信区间，-0.96至-0.17，P=0.005）的术后疼痛减轻。与对照组相比，静脉注射利多卡因对术后阿片类药物消耗量的影响显示出显著效果（加权均数差-15.36，95%可信区间，-21.40至-9.33mg静脉注射吗啡当量，P<0.001）。
这项对随机对照试验的定量分析表明，围手术期静脉注射利多卡因可有效减少脊柱手术患者的术后阿片类药物消耗量和疼痛。静脉注射利多卡因应被视为改善脊柱手术患者镇痛效果的有效辅助手段。然而，研究数量非常少，需要更多的研究。
