Effect Of Perioperative Intravenous Infusion Of Lidocaine On Postoperative Recovery After Laparoscopic Surgery

Section AEffect of perioperative intravenous infusion of lidocaine on postoperative recovery after laparoscopic surgery:meta analysisObjective:To evaluate the value of perioperative intravenous infusion of lidocaine for postoperative pain and recovery of intestinal function in patients after laparoscopic surgery.Methods:We searched the PubMed,The Cochrane Library,and Embase databases to search for articles that examined the effects of perioperative intravenous infusion of lidocaine and placebo or blank controls on pain and recovery in patients after laparoscopic surgery.All were built until January 2019.Results:We included a total of 21 studies,all of which were randomized controlled trials,totaling 1108 patients(554 patients in both the experimental and control groups).Results showed that the early pain scores in the lidocaine group were lower than those in the control group[SMD(95%CI)=-0.88(-1.40,-0.37),P=0.0007],and the postoperative morphine requirement was reduced[MD(95%CI)=-4.90(-7.77,-2.03),P=0.0008],increased Intestinal exhaust time[MD(95%CI)=-3.91(-7.21,-0,61),P=0.02],Increased patient satisfaction[SMD(95%CI)=0.62(0.33,0.91),P<0.0001],decreased postoperative nausea incidence[RR(95%CI)=0.69(0.53,0.90),P=0.007].Postoperative mid-term(24h)pain scores[SMD(95%CI)=-0.27(-0.46,-0.07),P=0.005],postoperative late(48h)pain score,first defecation time after surgery,hospital stay,the incidence of vomiting had no statistical/clinical significance.Conclusion:Intravenous lidocaine can reduce the early pain score after laparoscopic surgery,reduce the need for analgesic drugs,speed up intestinal exhaust,increase patient satisfaction,and reduce the incidence of postoperative nausea.Section BEffect of perioperative intravenous infusion of lidocaine on postoperative recovery after laparoscopic surgery:clinical observationObjective:To observe the effect of perioperative intravenous lidocaine on postoperative pain and recovery of intestinal function in patients undergoing laparoscopic surgery.Methods:Patients who underwent laparoscopic cholecystectomy or total uterine and/or accessory resection(n=98)were included in the study,excluding data loss due to different reasons,patients(n=87)were finally divided into control group(n=43)and lido group(n=44).After induction of general anesthesia,the first dose of bolus lidocaine(1.5mg/kg)was given,and lidocaine(1.5mg/kg/h)was continuously infused after the surgery until the end of the operation.Observations:pain scores(VAS visual analogue scale)at 2h,6h,24h,and 48h after surgery,time of first use of opioids after surgery,total dose of intraoperative opioids,recovery of gastrointestinal motility(first exhaust time),postoperative nausea,vomiting,length of hospital stay,and adverse reactions(irritability,dizziness,tinnitus,unclear speech,skeletal muscle twitching,lethargy,seizures,etc.)Results:There were 87 patients in our study.The demographic characteristics between the groups are similar.The VAS pain score of the lidocaine group was significantly lower at 2h,6h and 24h after surgery(P<0.05).The total amount of opioids and the incidence of nausea after treatment were significantly lower than those of the control group(P<0.05).No significant differences were observed in the time of first opioid use,postoperative vomiting,and hospital stay,and no serious adverse events were observed between two groups.Conclusion:Continuous infusion of lidocaine during the perioperative period can alleviate postoperative pain in patients undergoing laparoscopic surgery,and reduce total dose of postoperative opioids.