title: Perioperative systemic lidocaine for postoperative analgesia and recovery after abdominal surgery: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Postoperative pain management remains a significant challenge after abdominal surgery.
  
  
  OBJECTIVE
  The aim of this meta-analysis was to evaluate the efficacy of systemic lidocaine for postoperative pain management and recovery after abdominal surgery.
  
  
  METHODS
  Data were derived from Medline (1966-2010), CINAHL, The Cochrane Central Register of Controlled Trials, and Scopus.
  
  
  METHODS
  Randomized controlled trials of systemic administration of lidocaine for postoperative analgesia and recovery after abdominal surgery in adults, ie, >18 years, were considered.
  
  
  METHODS
  Combined data were analyzed with use of a random-effects model.
  
  
  METHODS
  Data on opioid consumption, postoperative pain intensity, opioid-related side effects, time to first flatus, time to first bowel movement, and length of hospital stay were extracted.
  
  
  RESULTS
  Twenty-one trials comparing systemic lidocaine with placebo or blank control for postoperative analgesia and recovery after abdominal surgery were included in this meta-analysis. Weighted mean difference for cumulative analgesic opioid (morphine) consumption 48 hours after surgery was -7.04 mg (95% CI: -10.40, -3.68, I2= 46.1%).Systemic lidocaine also significantly reduced postoperative pain intensity(visual analog scale, 0-100 mm) 6 hours after surgery at rest (weighted mean difference: -8.07 mm (95% CI: -14.69, -1.49); I2 = 90.6%) and during activity (weighted mean difference: -10.56 mm (95% CI: -16.89, -4.23), I2 = 82%). The time to first flatus and bowel movement was significantly shortened with lidocaine intervention by 6.92 hours (95% CI: -9.21, -4.63, I2 = 62.8%) and 11.74 hours (95% CI:-16.97, -6.51, I2 = 0). Moreover, systemic lidocaine also reduced hospital length of stay following the open procedure (weighted mean difference: -0.71 days (95% CI: -1.35, -0.07); I2 = 37.3%).
  
  
  CONCLUSIONS
  Heterogeneity of study results is the main limitation of this meta-analysis.
  
  
  CONCLUSIONS
  Perioperative systemic lidocaine may be a useful adjunct for postoperative pain management by decreasing postoperative pain intensity, reducing opioid consumption, facilitating GI function, and shortening length of hospital stay.
authors.affiliation: Department of Anesthesiology, TongRen Hospital, Capital Medical University, Beijing 100730, [corrected] China. sun00017@gmail.com
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Sun
authors.forename: Tianzuo
authors.initials: T
authors.lastname: Li
authors.forename: Nan
authors.initials: N
authors.lastname: Wang
authors.forename: Yue
authors.initials: Y
authors.lastname: Yun
authors.forename: Tong J
authors.initials: TJ
authors.lastname: Gan
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D003672:Defecation; D006801:Humans; D007262:Infusions, Intravenous; D007420:Intestine, Large / Q000502:physiology*; D007902:Length of Stay; D008012:Lidocaine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function / Q000187:drug effects; D013997:Time Factors
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D008012:Lidocaine