title: The Efficacy of Lidocaine in Laryngospasm Prevention in Pediatric Surgery: a Network Meta-analysis.
abstract: Higher incidence and worse outcomes of laryngospasm during general anesthesia in children than adults have been reported for many years, but few prevention measures are put forward. Efficacy of lidocaine in laryngospasm prevention has been argued for many years and we decided to design this network meta-analysis to assess the efficacy of lidocaine. We conducted an electronic search of six sources and finally included 12 Randomized Controlled Trials including 1416 patients. A direct comparison between lidocaine and placebo revealed lidocaine had the effect on preventing laryngospasm in pediatric surgery (RR = 0.46, 95% CI = [0.30, 0.70], P = 0.0002, I(2) = 0%). Both subgroup analysis and network analysis demonstrated that both intravenous lidocaine (subgroup: RR = 0.39, 95% CI = [0.18, 0.86], P = 0.02, I(2) = 38%; network: RR = 0.25, 95% CI = [0.04, 0.86]) and topical lidocaine (subgroup: RR = 0.37, 95% CI = [0.19, 0.72], P = 0.003, I(2) = 0%; network: RR = 0.14, 95% CI = [0.02, 0.55]) was effective in laryngospasm prevention, while no statistical difference was found in a comparison between intravenous and topical lidocaine. In conclusion, both intravenous and topical lidocaine are effective in laryngospasm prevention in pediatric surgery, while a comparison between them needs more evidences.
authors: Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.|Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.
authors: Xiaojing
authors: X
authors: Qi
authors: Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.|Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.
authors: Zhoupeng
authors: Z
authors: Lai
authors: Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.
authors: Si
authors: S
authors: Li
authors: Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.
authors: Xiaochen
authors: X
authors: Liu
authors: Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors: Zhongxing
authors: Z
authors: Wang
authors: Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors: Wulin
authors: W
authors: Tan
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007826:Laryngismus / Q000517:prevention & control*; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D014068:Tonsillectomy; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine