RESUMO
BACKGROUND: The administration of intravenous lidocaine during the peri-operative period may improve pain management after paediatric surgery. OBJECTIVE: To explore the decrease in postoperative pain intensity and opioid consumption associated with peri-operative lidocaine administration in the paediatric population. DESIGN: A systematic review with meta-analysis of randomised controlled trials and a Grading of Recommendations Assessment, Development and Evaluation (GRADE) analysis. DATA SOURCES: Extensive literature review. ELIGIBILITY CRITERIA: This study includes clinical trials conducted during surgery that examined the effect of intravenous lidocaine compared with placebo on postoperative pain management. RESULTS: Lidocaine administration decreased pain intensity in PACU (standardised mean difference (SMD)â=â-1.89 [-3.75, -0.03], I2â=â97%, P of I2â<â0.001) and on postoperative day 1 (SMDâ=â-2.02 [-3.37, -0.66], I2â=â96%, P of I2â<â0.001, number of studiesâ=â5). Lidocaine was associated with a decrease in opioid consumption on postoperative day 1 (SMDâ=â-1.2 [-2.19, -0.2], I2â=â93%, P of I2â<â0.001) but not on postoperative day 2 (SMDâ=â-1.73 [-3.9, 0.44], I2â=â96%, P of I2â<â0.001). GRADE analyses resulted in low-quality results. Subgroup analyses revealed that pain intensity in PACU and opioid consumption on postoperative day 1 decreased when lidocaine was administered during both the intra-operative and postoperative periods. CONCLUSIONS: The use of lidocaine is associated with improved pain management. However, further studies are needed to increase the level of evidence and determine the optimal administration regimen for pain management.