Perioperative lidocaine infusions may reduce the likelihood of developing chronic postsurgical pain, according to a systematic review and meta-analysis published in Pain.
The researchers conducted a systemic literature search of major medical databases from inception through October 2017. The study included 6 trials in which adults reported chronic postsurgical pain after undergoing noncardiac surgery (n=420). In these trials, study participants had no baseline pain and were randomly assigned to receive perioperative lidocaine infusion or placebo.
Perioperative lidocaine infusions were found to reduce the risk for procedure-related pain ≥3 months after surgery (odds ratio, 0.29; 95% CI, 0.18-0.48). Despite these results, the researchers noted that publication and other biases were highly apparent. Limitations in trial design were also present.
Although each study included a statement regarding the lack of adverse events attributable to lidocaine, systemic safety surveillance strategies were lacking.
“The hypothesis that perioperative lidocaine reduces [chronic postsurgical pain] should therefore be tested in a large, definitive, multicenter clinical trial that overcomes the limitations identified to date by measuring safety outcomes in detail,” the researchers wrote.
Bailey M, Corcoran T, Schug S, Toner A. Perioperative lidocaine infusions for the prevention of chronic post-surgical pain: a systematic review and meta-analysis of efficacy and safety. [published online May 11, 2018]. Pain. doi:10.1097/j.pain.0000000000001273