Neuroanaesthesia & neurocritical care
Procedure-specific effects of intravenous lidocaine in adult spine surgery: a systematic review and meta-analysis of randomized controlled trials
Pooled result · 9 trials, 655 patientsResult — go to the resultMD −0.83 95% CI −1.36 to −0.30Authors' conclusion
There is moderate-certainty evidence that perioperative intravenous lidocaine reduces postoperative pain and opioid consumption after adult spine surgery.
Study context
- Population
- Adults undergoing spine surgery10 RCTs
- Comparison
- Perioperative IV lidocaine infusion vs placebo or standard care
- Outcome
- Postoperative pain intensity
- Follow-up
- 24 hours
Methodological detailsrandom-effects, post hoc subgroup analysis by procedure type, meta-regression
- Random-effects
- Post hoc subgroup analysis by procedure type
- Meta-regression
Pooled result
9 trials, 655 patients
MD
−0.83
95% CI −1.36 to −0.30
P = 0.002
Lidocaine vs Placebo or standard care
MD −0.83 (95% CI −1.36 to −0.30); P = 0.002
As reported in the abstract
Further pooled results
| Outcome | MD (mg intravenous morphine equivalents) (95% CI) | P value | |
|---|---|---|---|
| Opioid consumption9 trials | −11.64 (−16.14 to −7.14) | P < 0.001 | |
| −20−10010Difference, mg intravenous morphine equivalents (linear scale) |
Pain at 24 h, instrumented fusion or complex spine surgery (subgroup)
- Clinically meaningful reduction with IV lidocaine, exceeding the minimal clinically important difference of 1.0 point: MD
- −1.23 (95% CI −1.81 to −0.64)
- Post hoc exploratory analysis
- Test for subgroup differences, p=0.005
Pain at 24 h, decompression (subgroup)
- Minimal reduction with IV lidocaine: MD
- −0.20 (95% CI −0.61 to 0.21)
- Post hoc exploratory analysis
- Test for subgroup differences, p=0.005
Between-study heterogeneity (meta-regression)
- Lidocaine infusion rate did not modify the treatment effect
- P = 0.97
- Baseline pain severity explained ≈53% of between-study heterogeneity
Postoperative nausea and vomiting (PONV) and length of stay (LOS)
- No significant effects
Original publication
Procedure-specific effects of intravenous lidocaine in adult spine surgery: a systematic review and meta-analysis of randomized controlled trials. Reg Anesth Pain Med. Published 3 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →