Intravenous lignocaine in colorectal surgery: a systematic review

MacFater, Wiremu; Rahiri, Jamie‐Lee; Lauti, Melanie; Su’a, Bruce; Hill, Andrew

doi:10.1111/ans.14084

Cited by 19 publications

(15 citation statements)

References 25 publications

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“…In the consumption of analgesics, our study showed that lidocaine was associated with lower opioid requirements in the first 24 hours after laparoscopic colorectal surgery, which was consistent with these studies . However, other studies showed that IV lidocaine could not reduce the consumption of opioids after other abdominal surgeries . The cause of this difference might be induced by the different type of surgery.…”

Section: Discussionsupporting

confidence: 89%

“…Lidocaine is a commonly used amide local anaesthetic with anti‐inflammatory and anti‐hyperalgesia effects. Previous meta‐analyses demonstrated that intravenous (IV) lidocaine could reduce postoperative pain and analgesia requirement, whereas the review of MacFater et al reported that IV lidocaine cannot effectively reduce early pain after colorectal surgery . Their findings were similar to the meta‐analysis that included 68 randomised controlled trials (RCTs), which showed that lidocaine had no advantage on enhancing gastrointestinal function recovery and reducing PONV and pain degree compared with placebo in various surgeries .…”

Section: Introductionmentioning

confidence: 84%

“…7,[9][10][11][12]29,30 However, other studies showed that IV lidocaine could not reduce the consumption of opioids after other abdominal surgeries. 3,13,14,22,29,31 The cause of this difference might be induced by the different type of surgery.…”

Section: Discussionmentioning

confidence: 99%

“…19 The first strength of this meta-analysis is its attempt to be more procedure-specific by including only laparoscopic colorectal surgery. A previous study by MacFater et al 13 included open and laparoscopic colorectal operations, and they did not perform meta-analysis because of heterogeneity in studies. Second, a recent meta-analysis by Cooke et al 14 included nine RCTs with 405 patients undergoing colorectal surgery and included only four laparoscopic colorectal surgery studies, 20-23 but we added another six studies 3,18,19,[24][25][26] to our meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

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The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

Shi

Zhang

Wei‐wei

et al. 2019

International Wound Journal

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To evaluate the efficacy of intravenous lidocaine in relieving postoperative pain and promoting rehabilitation in laparoscopic colorectal surgery, we conducted this meta‐analysis. The systematic search strategy was performed on PubMed, EMBASE, Chinese databases, and Cochrane Library before September 2019. As a result, 10 randomised clinical trials were included in this meta‐analysis (n = 527 patients). Intravenous lidocaine significantly reduced pain scores at 2, 4, 12, 24, and 48 hours on movement and 2, 4, and 12 hours on resting‐state and reduced opioid requirement in first 24 hours postoperatively (weighted mean difference [WMD] = −5.02 [−9.34, −0.70]; P = .02). It also decreased the first flatus time (WMD: −10.15 [−11.20, −9.10]; P < .00001), first defecation time (WMD: −10.27 [−17.62, −2.92]; P = .006), length of hospital stay (WMD: −1.05 [−1.89, −0.21]; P = .01), and reduced the incidence of postoperative nausea and vomiting (risk ratio: 0.53 [0.30, 0.93]; P = .03) when compared with control group. However, it had no effect on pain scores at 24 and 48 hours at rest, the normal dietary time, and the level of serum C‐reactive protein. In summary, perioperative intravenous lidocaine could alleviate acute pain, reduce postoperative analgesic requirements, and accelerate recovery of gastrointestinal function in patients undergoing laparoscopic colorectal surgery.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

Shi

Zhang

Wei‐wei

et al. 2019

International Wound Journal

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“…IVL is another adjunct used for its effectiveness in the acceleration of return of bowel function following colorectal resection surgery, a finding corroborated by both this NMA and several meta‐analyses. However, it remains unclear whether IVL decreases pain and opioid consumption to a clinically significant degree.…”

Section: Discussionmentioning

confidence: 66%

Network meta-analysis of local and regional analgesia following colorectal resection

Varghese

Bissett

et al. 2020

British Journal of Surgery

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Background Postoperative pain management after colorectal surgery remains challenging. Systemic opiates delivered on demand or via a patient‐controlled pump have traditionally been the mainstay of treatment. Opiate analgesia is associated with slower gastrointestinal recovery and unpleasant side‐effects; many regional and local analgesic techniques have been developed as alternatives. Methods MEDLINE, Embase and CENTRAL databases were searched systematically for RCTs comparing analgesic techniques after major colorectal resection. A network meta‐analysis was performed using a Bayesian random‐effects framework with a non‐informative prior. Primary outcomes included pain at rest and cumulative opiate consumption 24 h after surgery. Secondary outcomes included pain at rest and cumulative opiate consumption at 48 h, pain on movement and cough at 24 and 48 h, time to first stool, time to tolerance of oral diet, duration of hospital stay, nausea and vomiting, and postoperative complications. Results Seventy‐four RCTs, including 5101 patients and 11 different techniques, were included. Some inconsistency and heterogeneity was found. SUCRA scores showed that spinal analgesia was the best intervention for postoperative pain and opiate reduction at 24 h. Transversus abdominus plane blocks were effective in reducing pain and opiate consumption 24 h after surgery. Subgroup analysis showed similar results for open versus minimally invasive surgical approaches, and enhanced recovery after surgery programmes. Conclusion Spinal analgesia and transversus abdominus plane blocks best balanced pain control and opiate minimization in the immediate postoperative phase following colorectal resection. Multimodal analgesia reduces pain, minimizes systemic opiate use and optimizes postoperative recovery.

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Alvimopan retains efficacy in patients undergoing colorectal surgery within an established ERAS program

et al. 2022

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Intravenous lignocaine in colorectal surgery: a systematic review

Cited by 19 publications

References 25 publications

The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

Network meta-analysis of local and regional analgesia following colorectal resection

Alvimopan retains efficacy in patients undergoing colorectal surgery within an established ERAS program

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