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Perioperative intravenous lignocaine for pediatric postoperative pain-A systematic review and meta-analysis

Aakriti Gupta1, Vighnesh Ashok1

  • 1Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Paediatric Anaesthesia
|October 4, 2024
PubMed

Insights

Perioperative intravenous lignocaine (bolus followed by infusion) significantly reduced 24-hour opioid consumption in pediatric surgical patients. However, its impact on pain scores and rescue analgesia remains uncertain due to low-quality evidence.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Intravenous lignocaine is used as an analgesic adjunct in pediatric surgical patients.
  • Its efficacy in this population is not well-established.

Purpose of the Study:

  • To evaluate the efficacy of perioperative intravenous lignocaine (bolus followed by infusion) on postoperative pain outcomes in pediatric surgical patients.
  • To clarify the impact on opioid consumption, pain scores, and need for rescue analgesia.

Main Methods:

  • Systematic review and meta-analysis of studies published from inception to June 2024.
  • Included pediatric patients (≤18 years) undergoing general anesthesia.
  • Compared perioperative intravenous lignocaine with placebo, focusing on 24-hour opioid consumption.

Main Results:

  • Seven studies with 415 patients were included.
  • Intravenous lignocaine significantly reduced 24-hour postoperative morphine consumption compared to placebo (SMD -1.31, p=0.003).
  • Meta-analysis for secondary outcomes (pain scores, rescue analgesia) could not be performed.

Conclusions:

  • Low-quality evidence suggests perioperative intravenous lignocaine reduces postoperative opioid consumption in pediatric surgical patients.
  • The effect of lignocaine on postoperative pain scores and the need for rescue analgesia is uncertain.
Abstract

Keywords:
lidocainelignocaineopioid consumptionpain scorespediatric surgery

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