Perioperative Lidocaine May Reduce Risk for Chronic Postsurgical Pain

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The systematic review included 6 trials in which adults reported chronic postsurgical pain after undergoing noncardiac surgery.
The systematic review included 6 trials in which adults reported chronic postsurgical pain after undergoing noncardiac surgery.

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.

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Reference

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

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