• Chang-Hoon Koo, Junkyu Kim, Hyo-Seok Na, Jung-Hee Ryu, and Hyun-Jung Shin.
• Department of Anesthesiology & Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea.
• J Clin Anesth. 2022 Oct 1; 81: 110918.

Study ObjectiveThe role of lidocaine patch (LP) in reducing postoperative pain by local anesthetic absorption has been evaluated in several studies; however, these trials have shown inconsistent results. This meta-analysis aimed to identify the benefits of LP, focusing on its pain-reducing and morphine-sparing effect in patients after surgery.DesignMeta-analysis.SettingPublished randomized controlled trials (RCTs) comparing the analgesic effects of LP after surgery to those of placebo or no patch.PatientsEleven RCTs including 539 patients.InterventionsWe searched electronic databases to identify relevant RCTs.MeasurementsThe primary outcome was postoperative pain score up to 48 h assessed using a numerical rating or visual analog scale, and the secondary outcomes were postoperative morphine consumption and side effects. The effect size was estimated by calculating the mean difference (MD) or risk ratio (RR), with 95% confidence interval (CI).Main ResultsLP significantly decreased postoperative pain score at 6 h (MD, -1.85; 95% CI, -2.98 to -0.72; p = 0.001), 12 h (MD, -1.48; 95% CI, -2.07 to -0.88; p < 0.001), 24 h (MD, -1.18; 95% CI, -1.65 to -0.7; p < 0.001), and 48 h (MD, -1.33; 95% CI, -2.46 to -0.19; p = 0.022). In contrast, no significant effect on postoperative morphine consumption was observed at 24 h (MD, -3.48 mg; 95% CI, -7.94 to 0.98 mg; p = 0.127) or 48 h (MD, -5.29 mg; 95% CI, -13.28 to 2.71; p = 0.195). LP was unrelated to local (RR, 1.00, 95% CI, 0.67 to 1.49; p = 0.987) or systemic side effects (RR, 0.76, 95% CI, 0.52 to 1.11, p = 0.151).ConclusionsLP can lower postoperative pain without side effects, compared to placebo or no patch. However, its morphine-sparing effect remains unclear.Copyright © 2022 Elsevier Inc. All rights reserved.

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