Is Lidocaine Patch Beneficial for Postoperative Pain: A Meta-analysis of raNdomized Clinical Trials.

Abstract

The aim of this meta-analysis was to evaluate whether a lidocaine patch is beneficial for postoperative pain as an option for multimodal analgesia. Information was obtained from PubMed, Embase, and the Cochrane Central Register of Controlled Trials for clinical randomized controlled trials of lidocaine patches for postoperative pain (as of March 2022). Two researchers independently completed study screening, risk bias assessment, and data extraction. Review Manager (version 5.4, Cochrane collaboration) was used to conduct the meta-analysis. The evaluation metrics were postoperative pain scores, opioid consumption, and patient satisfaction. Sixteen randomized controlled trials were included, and data from 918 patients were available. Pain scores differed between the two groups at 12, 24, and 48 h postoperatively, and the pain scores of the lidocaine patch group were significantly lower (MD=-1.32 [95% CI: -1.96 to -0.68], P<0.0001; I2=92%) at 12 h after the operation; (MD=-1.23 [95% CI: -1.72 to -0.75], P<0.00001; I2=92%) at 24 h after the operation; and (MD=-0.25 [95% CI:-0.29 to -0.21], P<0.00001; I2=98%) at 48 h after the operation. In addition, the lidocaine patch group had decreased opioid requirements (MD=-3.57 [95% CI: -5.06 to -2.09], P<0.00001; I2=96%). The lidocaine patch group seemed to be more satisfied, but there was no significant difference [RR, 1.50 (95% CI: 0.74 to 3.05), P=0.26] between the groups. Lidocaine patches are beneficial for postoperative pain and can be used in multimodal analgesia to reduce opioid use, but there is no significant increase in patient satisfaction with pain control. More data are needed to support this conclusion due to the large heterogeneity in the present study.