PMID- 37297968
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230612
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 12
IP  - 11
DP  - 2023 May 31
TI  - Systemic Anti-Inflammatory Effects of Intravenous Lidocaine in Surgical Patients: 
      A Systematic Review and Meta-Analysis.
LID - 10.3390/jcm12113772 [doi]
LID - 3772
AB  - There has recently been increasing evidence that the use of perioperative 
      intravenous lidocaine infusion possesses analgesic, opioid-sparing and 
      anti-inflammatory effects in surgical patients. Although opioid-sparing and 
      analgesic properties have been strongly supported, the anti-inflammatory features 
      are not well established in elective surgery. Therefore, the aim of this 
      systematic review is to examine the effect of perioperative intravenous lidocaine 
      infusion on postoperative anti-inflammatory status in patients undergoing 
      elective surgery. A search strategy was created to identify suitable randomised 
      clinical trials (RCTs) in PubMed, Scopus, Web of Science and Clinicaltrials.gov 
      databases until January 2023. RCTs that evaluated the effect of intravenous 
      lidocaine infusion, compared with placebo, on adult patients who underwent 
      elective surgery, in inflammatory markers response were included. Exclusion 
      criteria consisted of paediatric patients, animal studies, non-RCT methodology, 
      intervention without intravenous lidocaine, inadequate control group, duplicated 
      samples, ongoing studies and lack of any relevant clinical outcome measures. The 
      following inflammatory markers-interleukin (IL)-6, tumour necrosis factor 
      (TNF)-alpha, IL-1RA, IL-8, IL-10, C-reactive protein (CRP), IL-1, IL-1beta, interferon 
      (IFN)-gamma, cortisol, IL-4, IL-17, high-mobility group protein B1 (HMGB1) and 
      transforming growth factor (TGF)-beta-were evaluated as outcomes in this review. A 
      total of 21 studies, including 1254 patients, were identified. Intravenous 
      lidocaine infusion significantly reduced the change from IL-6 baseline levels at 
      the end of surgery compared to a placebo (standardised mean difference [SMD]: 
      -0.647, 95% confidence interval [CI]: -1.034 to -0.260). Usage of lidocaine was 
      associated with a significant reduction in other postoperative pro-inflammatory 
      markers, such as TNF-alpha, IL-1RA, IL-8, IL-17, HMGB-1 and CRP. There was no 
      significant difference in other markers, such as IL-10, IL-1beta, IL-1, IFN-gamma, IL-4, 
      TGF-beta and cortisol. This systematic review and meta-analysis provide support for 
      the administration of perioperative intravenous lidocaine infusion as an 
      anti-inflammatory strategy in elective surgery.
FAU - Castro, Irene
AU  - Castro I
AUID- ORCID: 0000-0001-8507-6159
AD  - Department of Anesthesiology and Intensive Care Medicine, Instituto Portugues de 
      Oncologia do Porto (IPO-Porto), 4200-072 Porto , Portugal.
AD  - OncoPharma Research Group, Center for Health Technology and Services Research 
      (CINTESIS), Rua Doutor Placido da Costa, 4200-450 Porto, Portugal.
AD  - Faculty of Medicine, University of Porto, Alameda Professor Hernani Monteiro, 
      4200-319 Porto, Portugal.
FAU - Carvalho, Pedro
AU  - Carvalho P
AD  - Faculty of Medicine, University of Porto, Alameda Professor Hernani Monteiro, 
      4200-319 Porto, Portugal.
FAU - Vale, Nuno
AU  - Vale N
AUID- ORCID: 0000-0002-1283-1042
AD  - OncoPharma Research Group, Center for Health Technology and Services Research 
      (CINTESIS), Rua Doutor Placido da Costa, 4200-450 Porto, Portugal.
AD  - CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor 
      Hernani Monteiro, 4200-319 Porto, Portugal.
AD  - Department of Community Medicine, Health Information and Decision (MEDCIDS), 
      Faculty of Medicine, University of Porto, Rua Doutor Placido da Costa, 4200-450 
      Porto, Portugal.
FAU - Monjardino, Teresa
AU  - Monjardino T
AUID- ORCID: 0000-0003-4944-3366
AD  - Cancer Epidemiology Group, Centro de Investigacao do Instituto Portugues de 
      Oncologia do Porto (CI-IPOP), 4200-072 Porto, Portugal.
FAU - Mourao, Joana
AU  - Mourao J
AD  - CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor 
      Hernani Monteiro, 4200-319 Porto, Portugal.
AD  - Department of Anesthesiology, Centro Hospitalar Universitario de Sao Joao, 
      Alameda Professor Hernani Monteiro, 4200-319 Porto, Portugal.
AD  - Surgery and Physiology Department, Faculty of Medicine, University of Porto, Rua 
      Doutor Placido da Costa, 4200-450 Porto, Portugal.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230531
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC10253813
OTO - NOTNLM
OT  - cytokines
OT  - elective surgery
OT  - inflammatory response
OT  - intravenous
OT  - lidocaine
OT  - meta-analysis
COIS- The authors declare no conflict of interest.
EDAT- 2023/06/10 15:13
MHDA- 2023/06/10 15:14
PMCR- 2023/05/31
CRDT- 2023/06/10 01:09
PHST- 2023/05/07 00:00 [received]
PHST- 2023/05/28 00:00 [revised]
PHST- 2023/05/29 00:00 [accepted]
PHST- 2023/06/10 15:14 [medline]
PHST- 2023/06/10 15:13 [pubmed]
PHST- 2023/06/10 01:09 [entrez]
PHST- 2023/05/31 00:00 [pmc-release]
AID - jcm12113772 [pii]
AID - jcm-12-03772 [pii]
AID - 10.3390/jcm12113772 [doi]
PST - epublish
SO  - J Clin Med. 2023 May 31;12(11):3772. doi: 10.3390/jcm12113772.