World Journal of Surgery

, Volume 39, Issue 9, pp 2220–2234 | Cite as

Efficacy of Intravenous Lidocaine for Postoperative Analgesia Following Laparoscopic Surgery: A Meta-Analysis

  • Nicholas T. VenthamEmail author
  • Ewan D. Kennedy
  • Richard R. Brady
  • Hugh M. Paterson
  • Doug Speake
  • Irwin Foo
  • Kenneth C.  H.  Fearon
Original Scientific Report



Intravenous (IV) lidocaine has analgesic and anti-inflammatory properties. This study aims to evaluate the efficacy of IV lidocaine in controlling postoperative pain following laparoscopic surgery.


A meta-analysis of randomised controlled trials (RCTs) comparing IV lidocaine versus placebo/routine treatment for postoperative analgesia following laparoscopic surgery. The primary outcome was opiate requirement at 24 h. Secondary outcomes included cumulative opiate requirement, numerical pain scores (2, 12, 24, 48 h at rest and on movement), recovery indices (nausea and vomiting, length of stay, time until diet resumption, first flatus and bowel movement) and side effects (cardiac/neurological toxicity). Subgroup analyses were performed according to operation type and to compare IV lidocaine with intraperitoneal lidocaine.


Fourteen RCTs with 742 patients were included. IV lidocaine was associated with a small but significant reduction in opiate requirement at 24 h compared with placebo/routine care. IV lidocaine was associated with reduced cumulative opiate requirement, reduced pain scores at rest at 2, 12 and 24 h, reduced nausea and vomiting and a shorter time until resumption of diet. The length of stay did not differ between groups. There was a low incidence of IV lidocaine-associated toxicity. In subgroup analyses, there was no difference between IV and intraperitoneal lidocaine in the measured outcomes.


IV lidocaine has a multidimensional effect on the quality of recovery. IV lidocaine was associated with lower opiate requirements, reduced nausea and vomiting and a shorter time until resumption of diet. Whilst IV lidocaine appears safe, the optimal treatment regimen remains unknown. Statistical heterogeneity was high.


Lidocaine Pain Score Laparoscopic Cholecystectomy Postoperative Analgesia Transversus Abdominis Plane 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We would like to thank all of the corresponding authors who responded to requests for supplementary data.

Conflict of interests

No conflicts of interest to declare.

Supplementary material

268_2015_3105_MOESM1_ESM.pdf (88 kb)
Supplementary material 1 (PDF 88 kb)
268_2015_3105_MOESM2_ESM.pdf (1.3 mb)
Supplementary material 2 (PDF 1301 kb)


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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Nicholas T. Ventham
    • 1
    Email author
  • Ewan D. Kennedy
    • 1
  • Richard R. Brady
    • 1
  • Hugh M. Paterson
    • 1
  • Doug Speake
    • 1
  • Irwin Foo
    • 2
  • Kenneth C.  H.  Fearon
    • 1
  1. 1.Department of Colorectal SurgeryWestern General HospitalEdinburghUK
  2. 2.Department of AnaesthesiaWestern General HospitalEdinburghUK

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