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静脉应用利多卡因在腹腔镜结直肠手术后的术后疼痛管理中的疗效:RCT 的荟萃分析和荟萃回归。

Efficacy of Intravenous Use of Lidocaine in Postoperative Pain Management After Laparoscopic Colorectal Surgery: A Meta-analysis and Meta-regression of RCTs.

机构信息

Department of Anesthesiology, University Hospital of Larissa, Larissa, Greece.

Department of Surgery, University Hospital of Larissa, Larissa, Greece.

出版信息

In Vivo. 2021 Nov-Dec;35(6):3413-3421. doi: 10.21873/invivo.12641.

Abstract

BACKGROUND/AIM: Current literature reports regarding the effect of lidocaine in laparoscopic colectomies are still inconclusive. The purpose of this study was to review the current literature and estimate the overall effect of intravenous lidocaine administration in postoperative recovery of patients submitted to laparoscopic colectomies.

MATERIALS AND METHODS

This study was completed based on the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic screening using scholar databases was performed (Medline, Scopus, Web of Science, CENTRAL).

RESULTS

In total, 8 studies and 407 patients were included in this meta-analysis. Introduction of intravenous lidocaine in the perioperative analgesia scheme did not improve hospitalization duration (p=0.23), morphine consumption (p=0.96), perioperative bowel function (first flatus p=0.40, first bowel opened p=0.13, first diet p=0.16), or the overall complication rates (p=0.42). Overall, high heterogeneity levels were identified.

CONCLUSION

Current evidence indicates that lidocaine does not improve rehabilitation after laparoscopic colectomies.

摘要

背景/目的:目前关于利多卡因对腹腔镜结肠切除术影响的文献报道仍不一致。本研究旨在回顾当前文献,评估静脉内给予利多卡因对接受腹腔镜结肠切除术患者术后恢复的总体影响。

材料和方法

本研究基于 PRISMA 指南和 Cochrane 干预系统评价手册进行。使用学者数据库进行了系统筛选(Medline、Scopus、Web of Science、CENTRAL)。

结果

共有 8 项研究和 407 例患者纳入本荟萃分析。在围手术期镇痛方案中引入静脉内利多卡因并未改善住院时间(p=0.23)、吗啡消耗量(p=0.96)、围手术期肠道功能(首次排气 p=0.40、首次排便 p=0.13、首次进食 p=0.16)或总体并发症发生率(p=0.42)。总体而言,存在较高的异质性水平。

结论

目前的证据表明,利多卡因不能改善腹腔镜结肠切除术后的康复。

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