Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery

Background: Continuous intravenous administration of lidocaine may decrease the duration of ileus and pain after abdominal surgery. Methods: Three databases (Medline, Embase and the Cochrane Controlled Trials Register) were searched to retrieve randomized controlled trials comparing continuous intravenous lidocaine infusion during and after abdominal surgery with placebo. Study design was scored using the Oxford Quality Score based on randomization, double-blinding and follow-up. Outcome measures were duration of ileus, length of hospital stay, postoperative pain, and incidence of nausea and vomiting. Results: Eight trials were selected. A total of 161 patients received, intravenous lidocaine, with 159 controls. Intravenous lidocaine administration decreased the duration of ileus (weighted mean difference (WMD) -8-36 h; P < 0.001), length of hospital stay (WMD -0.84 days; P = 0.002), postoperative pain intensity at 24 h after operation on a 0-100-mm visual analogue scale (WMD -5.93 mm; P = 0.002), and the incidence of nausea and vomiting (odds ratio 0.39; P = 0.006). Conclusion: Continuous intravenous administration of lidocaine during and after abdominal surgery improves patient rehabilitation and shortens hospital stay.