TY - JOUR
T1 - The analgesic effect of intravenous lidocaine versus intrawound or epidural bupivacaine for postoperative opioid reduction in spine surgery
T2 - A systematic review and meta-analysis
AU - Tsai, Sung Huang Laurent
AU - Yolcu, Yagiz Ugur
AU - Hung, Shao Wen
AU - Kurian, Shyam J.
AU - Alvi, Mohammed Ali
AU - Fu, Tsai Sheng
AU - Bydon, Mohamad
N1 - Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2021/2
Y1 - 2021/2
N2 - Background: Pain management following spine surgery remains a challenge. The significant use of opioids may lead to opioid-related adverse events. These complications can increase perioperative morbidity and rapidly expend health care resources by developing chronic pain. Although intraoperative pain control for surgery has been studied in the literature, a thorough assessment of the effect in spine surgery is rarely reported. The objective of the present study was to examine the outcomes of intraoperative intravenous lidocaine and intrawound or epidural bupivacaine use in spine surgery. Methods: An electronic literature search was conducted for studies on the use of lidocaine and bupivacaine in spine surgery for all years available. Only articles in English language were included. Postoperative opioid consumption, VAS score, nausea/vomiting, and length of hospital stay comprised the outcomes of interest. Pooled descriptive statistics with Risk Ratios (RR), Mean Differences (MD) and 95 % confidence interval were used to synthesize the outcomes for each medication. Results: A total of 10 studies (n = 579) were included in the analysis. Comparison of the opioid consumption revealed a significant mean difference between lidocaine and bupivacaine (MD: −12.25, and MD: −0.4, respectively, p = 0.01), favoring lidocaine. With regard to postoperative VAS, the pooled effect of both groups decreased postoperative pain (MD: −0.61 (95 % CI: −1.14, −0.08)), with a more significant effect in the lidocaine group (MD: −0.84, (95 % CI: −1.21, −0.48)). There was no significant effect in length of stay, and postoperative nausea/vomiting. Conclusions: The results of the present meta-analysis indicate that lidocaine and bupivacaine use may decrease postoperative pain and opioid consumption. Lidocaine had a stronger effect on the reduction of opioid consumption compared to bupivacaine.
AB - Background: Pain management following spine surgery remains a challenge. The significant use of opioids may lead to opioid-related adverse events. These complications can increase perioperative morbidity and rapidly expend health care resources by developing chronic pain. Although intraoperative pain control for surgery has been studied in the literature, a thorough assessment of the effect in spine surgery is rarely reported. The objective of the present study was to examine the outcomes of intraoperative intravenous lidocaine and intrawound or epidural bupivacaine use in spine surgery. Methods: An electronic literature search was conducted for studies on the use of lidocaine and bupivacaine in spine surgery for all years available. Only articles in English language were included. Postoperative opioid consumption, VAS score, nausea/vomiting, and length of hospital stay comprised the outcomes of interest. Pooled descriptive statistics with Risk Ratios (RR), Mean Differences (MD) and 95 % confidence interval were used to synthesize the outcomes for each medication. Results: A total of 10 studies (n = 579) were included in the analysis. Comparison of the opioid consumption revealed a significant mean difference between lidocaine and bupivacaine (MD: −12.25, and MD: −0.4, respectively, p = 0.01), favoring lidocaine. With regard to postoperative VAS, the pooled effect of both groups decreased postoperative pain (MD: −0.61 (95 % CI: −1.14, −0.08)), with a more significant effect in the lidocaine group (MD: −0.84, (95 % CI: −1.21, −0.48)). There was no significant effect in length of stay, and postoperative nausea/vomiting. Conclusions: The results of the present meta-analysis indicate that lidocaine and bupivacaine use may decrease postoperative pain and opioid consumption. Lidocaine had a stronger effect on the reduction of opioid consumption compared to bupivacaine.
KW - Bupivacaine
KW - Lidocaine
KW - Opioid consumption
KW - Postoperative pain
KW - Spine surgery
UR - http://www.scopus.com/inward/record.url?scp=85098631626&partnerID=8YFLogxK
U2 - 10.1016/j.clineuro.2020.106438
DO - 10.1016/j.clineuro.2020.106438
M3 - 文献综述
C2 - 33385933
AN - SCOPUS:85098631626
SN - 0303-8467
VL - 201
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
M1 - 106438
ER -