Background

In surgical patients undergoing general anaesthesia, coughing at the time of extubation is common and can result in potentially dangerous complications. We performed a systematic review and meta-analysis to assess the efficacy and safety of i.v. lidocaine administration during the perioperative period to prevent cough and other airway complications.

Methods

We searched Medical Literature Analysis and Retrieval System, Excerpta Medica database, and Cochrane Central Register of Controlled Trials for RCTs comparing the perioperative use of i.v. lidocaine with a control group in adult patients undergoing surgery under general anaesthesia. The RCTs were assessed using risk-of-bias assessment, and the quality of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).

Results

In 16 trials (n=1516), the administration of i.v. lidocaine compared with placebo or no treatment led to large reductions in post-extubation cough (risk ratio [RR]: 0.64; 95% confidence interval [CI]: 0.48–0.86) and in postoperative sore throat at 1 h (RR: 0.46; 95% CI: 0.32–0.67). There was no difference in incidence of laryngospasm (risk difference [RD]: 0.02; 95% CI: –0.07 to 0.03) or incidence of adverse events related to the use of lidocaine.

Conclusions

The use of i.v. lidocaine perioperatively decreased airway complications, including coughing and sore throat. There was no associated increased risk of harm.

中文翻译：

---

静脉注射利多卡因预防成人术后气道并发症：系统评价和荟萃分析

背景

在接受全身麻醉的手术患者中，拔管时的咳嗽很常见，并且可能导致潜在的危险并发症。我们进行了系统的回顾和荟萃分析，以评估围手术期静脉注射利多卡因预防咳嗽和其他气道并发症的有效性和安全性。

方法

我们搜索了医学文献分析和检索系统，Excerpta Medica数据库以及对照试验的Cochrane中央登记册中的RCT，以比较在全身麻醉下接受手术的成年患者静脉注射利多卡因与对照组的围手术期使用情况。使用偏见风险评估对RCT进行评估，并使用建议，评估，发展和评估等级（GRADE）评估证据质量。

结果

在16个试验（n = 1516）中，与安慰剂或不进行安慰剂治疗相比，静脉注射利多卡因可导致拔管后咳嗽的大幅度减少（风险比[RR]：0.64； 95％置信区间[CI]：0.48–0.86）术后1 h喉咙痛（RR：0.46； 95％CI：0.32-0.67）。喉痉挛的发生率（风险差异[RD]：0.02； 95％CI：–0.07至0.03）或与利多卡因使用相关的不良事件发生率无差异。

结论

围手术期静脉注射利多卡因可减少气道并发症，包括咳嗽和喉咙痛。没有相关的伤害风险增加。