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

Background: Intravenous lignocaine has been used as an analgesic adjunct in pediatric surgical patients, although its efficacy is still unclear.

Objective: We aimed to clarify the efficacy of perioperative intravenous lignocaine (bolus followed by an infusion) on pediatric postoperative pain outcomes.

Design: A systematic review and meta-analysis.

Data sources: PubMed, EMBASE, Web of Science, Google Scholar (inception to June 2024).

Eligibility criteria: Studies involving pediatric patients (≤18 years) undergoing surgery under general anesthesia with one group receiving perioperative intravenous lignocaine (bolus followed by infusion) and the other group receiving placebo. The primary outcome was 24-h postoperative opioid consumption. Postoperative pain scores and the need for rescue analgesia were the secondary outcomes.

Results: Seven studies (n = 415) were included in the final meta-analysis. The use of intravenous lignocaine significantly reduced the morphine consumption in the first 24 h after surgery, compared to placebo (SMD -1.31, 95% CI -2.18 to -0.43, p = 0.003). A meta-analysis could not be performed for the secondary outcomes.

Conclusion: There is low quality evidence to suggest that perioperative intravenous lignocaine bolus followed by an infusion significantly reduced the opioid consumption on the first postoperative day in pediatric surgical patients. The effects of perioperative lignocaine on postoperative pain scores and the need for rescue analgesia are uncertain.