title: Efficacy of lidocaine on preventing incidence and severity of pain associated with propofol using in pediatric patients: A PRISMA-compliant meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Propofol injection pain was considered as one conundrum during clinical anesthesia. The systematic review about the effect of lidocaine in reducing injection pain among children has not been established. The aim of the study was to systematically evaluate the efficacy and safety of such intervention.
  
  
  METHODS
  The literature search was performed from the inception to the May 31, 2016 in PubMed, Ovid EMBASE, and Cochrane database. All randomized controlled trials that using lidocaine for propofol injection pain in children were enrolled. The primary outcome included the incidence of injection pain and the incidence of propofol injection pain in different degrees. The data were combined to calculate the relative ratio and relevant 95% confidence interval. A meta-analysis was performed following the guidelines of the Cochrane Reviewer's Handbook and the PRISMA statement.
  
  
  RESULTS
  Data from the included 11 studies indicated that the incidence of injection pain was lower in lidocaine group than the incidence in saline control group and in propofol lipuro (medium- and long-chain triglycerides) group (pain occurrence: 22.1% in lidocaine vs 66.8% in saline, RR with 95% 0.34 [0.26, 0.43], I = 38%; 30.5% in lidocaine vs 46.9% in propofol lipuro, RR with 95% 0.68 [0.46, 1.00], I = 9%). There was no difference between lidocaine and ketamine/alfentanil both in reducing pain occurrence and in reducing pain severity (pain occurrence: 29.7% in lidocaine vs 25.8% in ketamine, RR with 95% 1.47 [0.16, 13.43], I = 94%; 31.0% in lidocaine vs 30.7% in alfentanil, RR with 95% 1.01 [0.69, 1.46], I = 11%). And the reported side effects revealed that the safety of lidocaine in pediatric patients was acceptable.
  
  
  CONCLUSIONS
  Compared with ketamine and alfentanil, lidocaine would be served as one more effective treatment in consideration of its well-matched efficacy, acceptable accessibility, and reasonable safety. However, more high-quality evidences in pediatric patients are necessary.
authors.affiliation: Department of Pharmacy, West China Second University Hospital, Sichuan University Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Evidence-Based Pharmacy Center, West China Second University Hospital Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Bing-Chen
authors.initials: BC
authors.lastname: Lang
authors.forename: Chun-Song
authors.initials: CS
authors.lastname: Yang
authors.forename: Ling-Li
authors.initials: LL
authors.lastname: Zhang
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Zhang
authors.forename: Yu-Zhi
authors.initials: YZ
authors.lastname: Fu
mesh_terms: D000293:Adolescent; D015760:Alfentanil / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002648:Child; D004311:Double-Blind Method; D006801:Humans; D015994:Incidence; D007649:Ketamine / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage*; D010146:Pain / Q000139:chemically induced* / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D015760:Alfentanil; D007649:Ketamine; D008012:Lidocaine; D015742:Propofol