Efficacy of intravenous lidocaine in controlling emergence agitation in children for surgery under sevoflurane anesthesia: a meta-analysis.
- Author:
Nina Kashka E. Pamintuan
;
Ana Maria de la Cerna
- Publication Type:Journal Article
- Keywords:
sevoflurane anesthesia
- MeSH:
lidocaine;
emergence agitation/delirium;
children;
pediatrics;
anesthesia;
general anesthesia
- From:
The Philippine Children’s Medical Center Journal
2023;19(1):47-61
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND:Emergence delirium is a state of mental confusion and agitation after wakening
from anesthesia that may result in traumatic injuries to the child. Limited drugs have been studied or
used to prevent this occurrence.
OBJECTIVE:To determine the efficacy and safety of intravenous lidocaine in controlling emergence agitation (EA) in children undergoing surgeries done under general anesthesia compared to
placebo or other intravenous anesthetics.
METHODOLOGY:This study is a meta-analysis, where published articles were obtained using
PubMed, Cochrane Library, Clinical Trials, and Google Scholar up to August 2022. The primary
outcome measure includes incidence of emergence delirium while secondary outcomes are postoperative pain and adverse effects comparing lidocaine and other intravenous drugs. The latter includes nausea and vomiting, untoward airway events and local anesthetic toxicity (LAST). Review Manager 5.4 was used for statistical analysis.
RESULTS:There were a total of 6 articles included for quantitative and qualitative analysis. The
overall incidence of emergence agitation (RR=1.03, 95% CI [0.50, 2.13], P=0.94) and adverse events
were higher in the Lidocaine group, although the differences were not significant. Subgroup analysis
by comparator showed significant increased risk of developing EA with Lidocaine compared to other
intravenous drugs (RR=2.06, 95% CI [1.32, 2.32], P=0.002). The risk for developing postoperative
pain is decreased with Lidocaine compared to placebo and other drugs.
CONCLUSION:Intravenous lidocaine given to children undergoing general anesthesia with
sevoflurane increased their risk for emergence delirium, compared to both placebo and other intravenous anesthetics.
- Full text:19(1)_51.pdf
