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利多卡因输注在腹腔镜胆囊切除术中的应用:一项更新的系统评价和荟萃分析。

The use of lidocaine infusion in laparoscopic cholecystectomy: An updated systematic review and meta-analysis.

作者信息

Awan Bakhtawar, Elsaigh Mohamed, Elkomos Beshoy Effat, Sohail Azka, Asqalan Ahmad, Baqar Safa Owhida Mousa, Elgendy Noha Ahmed, Saleh Omnia S, Szul Justyna Malgorzata, Juan Anna San, Alasmar Mohamed, Marzouk Mohamed Mustafa

机构信息

Department of General and Emergency Surgery, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK.

Department of Thoracic Surgery, Norfolk and Norwich University Hospital, Norwich, UK.

出版信息

J Minim Access Surg. 2024 Jul 1;20(3):239-246. doi: 10.4103/jmas.jmas_265_23. Epub 2024 Jan 19.


DOI:10.4103/jmas.jmas_265_23
PMID:38240330
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11354941/
Abstract

Being one of the most common abdominal surgical procedures, numerous techniques have been adapted to decrease post-operative pain post cholecystectomy. However, the efficacy of intravenous (IV) lidocaine in managing post operative pain after LC is still controversial, according to many recent studies. This study aims to detect the effectiveness of IV lidocaine compared to other medications in managing post-operative pain. PubMed, Scopes, Web of Science and Cochrane Library were searched for eligible studies from inception to June 2023, and a systematic review and meta-analysis was done. According to eligibility criteria, 14 studies (898 patients) were included in our study. The pooled results of the included studies showed that the pain score after 6, 12 and 24 h after the surgery was significantly lower in those who received IV lidocaine as a painkiller (Visual Analogue Scale [VAS] 6H, mean difference [MD] = -1.20, 95% confidence interval [CI] = -2.20, -0.20, P = 0.02; I2 = 98%, VAS 12H, MD = -0.90, 95% CI = -1.52, -0.29, P = 0.004; I2 = 96% and VAS 24H, MD = -0.86, 95% CI = -1.48, -0.24, P = 0.007; I2 = 92%). In addition, IV lidocaine is associated with a significant decrease in the opioid requirement after the surgery (opioid requirements, MD = -29.53, 95% CI = -55.41, -3.66, P = 0.03; I2 = 98%). However, there was no statistically significant difference in the incidence of nausea and vomiting after the surgery between the two groups (nausea and vomiting, relative risk = 0.91, 95% CI = 0.57, 1.45, P = 0.69; I2 = 50%). Lidocaine infusion in LC is associated with a significant decrease in post operative pain and in opioid requirements after the surgery.

摘要

作为最常见的腹部外科手术之一,已经采用了多种技术来减轻胆囊切除术后的疼痛。然而,根据最近的许多研究,静脉注射利多卡因在腹腔镜胆囊切除术后疼痛管理中的疗效仍存在争议。本研究旨在检测静脉注射利多卡因与其他药物相比在术后疼痛管理中的有效性。检索了PubMed、Scopus、Web of Science和Cochrane图书馆从创刊到2023年6月的符合条件的研究,并进行了系统评价和荟萃分析。根据纳入标准,本研究纳入了14项研究(898例患者)。纳入研究的汇总结果显示,接受静脉注射利多卡因作为止痛药的患者在术后6、12和24小时的疼痛评分显著更低(视觉模拟量表[VAS]6小时,平均差值[MD]=-1.20,95%置信区间[CI]=-2.20,-0.20,P=0.02;I2=98%,VAS 12小时,MD=-0.90,95%CI=-1.52,-0.29,P=0.004;I2=96%,VAS 24小时,MD=-0.86,95%CI=-1.48,-0.24,P=0.007;I2=92%)。此外,静脉注射利多卡因与术后阿片类药物需求量显著减少相关(阿片类药物需求量,MD=-29.53,95%CI=-五十五点四一,-3.66,P=0.03;I2=98%)。然而,两组术后恶心呕吐的发生率没有统计学上的显著差异(恶心呕吐,相对风险=0.91,95%CI=0.57,1.45,P=0.69;I2=50%)。腹腔镜胆囊切除术中输注利多卡因与术后疼痛显著减轻和术后阿片类药物需求量减少相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0752/11354941/5cedab578031/JMAS-20-239-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0752/11354941/6311d8346c0d/JMAS-20-239-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0752/11354941/417bc15fd528/JMAS-20-239-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0752/11354941/247245ecc9c8/JMAS-20-239-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0752/11354941/5cedab578031/JMAS-20-239-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0752/11354941/6311d8346c0d/JMAS-20-239-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0752/11354941/417bc15fd528/JMAS-20-239-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0752/11354941/247245ecc9c8/JMAS-20-239-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0752/11354941/5cedab578031/JMAS-20-239-g004.jpg

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引用本文的文献

[1]
Comparison of intraoperative intravenous lidocaine infusion and transversus abdominis plane block for postoperative analgesia following laparoscopic cholecystectomy: a randomized controlled trial.

Anesth Pain Med (Seoul). 2025-5-1

[2]
National trends in perioperative epidural analgesia use for surgical patients.

J Clin Anesth. 2024-12

本文引用的文献

[1]
Efficacy of prolonged intravenous lidocaine infusion for postoperative movement-evoked pain following hepatectomy: a double-blinded, randomised, placebo-controlled trial.

Br J Anaesth. 2023-7

[2]
Efficacy of intraoperative intravenous lidocaine infusion on postoperative opioid consumption after laparoscopic cholecystectomy: a randomized controlled trial.

Langenbecks Arch Surg. 2023-5-18

[3]
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J Coll Physicians Surg Pak. 2023-1

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Readmissions after cholecystectomy in a tertiary UK centre: Incidence, causes and burden.

J Minim Access Surg. 2022

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Anaesthesia. 2021-2

[6]
Intravenously injected lidocaine or magnesium improves the quality of early recovery after laparoscopic cholecystectomy: A randomised controlled trial.

Eur J Anaesthesiol. 2021-3-1

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Intraperitoneal Bupivacaine as Post-laparoscopic Cholecystectomy Analgesia.

J Coll Physicians Surg Pak. 2020-1

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BMC Anesthesiol. 2019-11-4

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Cochrane Database Syst Rev. 2019-10-3

[10]
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Br J Anaesth. 2019-7-11

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