Perioperative Intravenous Lidocaine Infusion Versus Placebo for Opioid Consumption Reduction in Abdominal Surgery: A Systematic Review and Meta-Analysis


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Article DOI: https://doi.org/10.64573/torgj2604001

Authors: Chiamaka Serena Chima1*

¹ Benjamin S. Carson (SNR) College of Health and Medical Sciences, Babcock University, Ilishan-Remo, Ogun State, Nigeria.

Cite:

  • APA (7th edition): Chima, C. S. (2026, June 12). Perioperative intravenous lidocaine infusion versus placebo for opioid consumption reduction in abdominal surgery: A systematic review and meta-analysis. The Operating Room Global Journal (TORGJ), 2(2). https://doi.org/10.64573/torgj2604001
  • Harvard: Chima, C.S., 2026. Perioperative intravenous lidocaine infusion versus placebo for opioid consumption reduction in abdominal surgery: A systematic review and meta-analysis. The Operating Room Global Journal (TORGJ), 2(2). Published 12 June. Available at: https://doi.org/10.64573/torgj2604001
  • Vancouver: Chima CS. Perioperative intravenous lidocaine infusion versus placebo for opioid consumption reduction in abdominal surgery: A systematic review and meta-analysis. The Operating Room Global Journal (TORGJ). 2026 Jun 12;2(2). https://doi.org/10.64573/torgj2604001
  • MLA (9th edition): Chima, Chiamaka Serena. “Perioperative Intravenous Lidocaine Infusion Versus Placebo for Opioid Consumption Reduction in Abdominal Surgery: A Systematic Review and Meta-Analysis.” The Operating Room Global Journal (TORGJ), vol. 2, no. 2, 12 June 2026, https://doi.org/10.64573/torgj2604001
  • Chicago (Author-Date): Chima, Chiamaka Serena. 2026. “Perioperative Intravenous Lidocaine Infusion Versus Placebo for Opioid Consumption Reduction in Abdominal Surgery: A Systematic Review and Meta-Analysis.” The Operating Room Global Journal (TORGJ) 2 (2), June 12. https://doi.org/10.64573/torgj2604001
ABSTRACT
Background: Postoperative opioid consumption after abdominal surgery contributes to delayed recovery, nausea, and long-term opioid dependence. Perioperative intravenous (IV) lidocaine infusion has been proposed as an opioid-sparing multimodal analgesic adjunct.
Methods: Following PRISMA 2020 guidelines, we searched PubMed, Embase, and ClinicalTrials.gov from inception to 15 March 2026. Eligible studies were randomised controlled trials comparing perioperative IV lidocaine infusion versus placebo in adult patients undergoing abdominal surgery under general anaesthesia. The primary outcome was cumulative postoperative opioid consumption at 24 and 48 hours. Secondary outcomes included pain scores, postoperative nausea and vomiting (PONV), length of hospital stay, and adverse events. Data were pooled using random-effects models; heterogeneity, risk of bias, and evidence quality were evaluated.
Results: 52 RCTs (n = 3,812 patients) were included. Perioperative IV lidocaine reduced 24-hour opioid consumption (weighted mean difference -8.7 mg morphine equivalents, 95% CI -12.4 to -5.0; I2 = 68%) and 48-hour consumption (WMD -11.2 mg, 95% CI -15.8 to -6.6; I2 = 72%). Pain scores at rest and on movement were lower at all assessed time points. Time to first flatus and bowel movement decreased, PONV incidence was reduced (risk ratio 0.68, 95% CI 0.54-0.86), and hospital length of stay was shortened by 0.6 days.
Conclusions: Perioperative IV lidocaine infusion is an effective and safe opioid-sparing strategy that reduces postoperative opioid consumption, pain, and accelerates recovery after abdominal surgery. These findings support its integration into enhanced recovery after surgery (ERAS) protocols and multimodal analgesia regimens.
Keywords: Lidocaine; Analgesic, Opioid; Abdominal Surgery; Opioid-Sparing

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