Original article Lidocaine patch for acute pain management: a meta-analysis of prospective controlled trials

Abstract Background:Local anesthetic is one of the cornerstones of multimodal analgesia. We investigated the efficacy of thelidocaine patch for acute pain management.Methods:We searched MEDLINE, CINAHL, Scopus, and the Cochrane Controlled Trials Register for publishedprospective controlled clinical trials that evaluated the analgesic effect of the lidocaine patch for acute orpostoperative pain management (1966–2014). The outcomes were postoperative opioid consumption, painintensity and length of hospital stay.Results:Five trials comparing the lidocaine patch with control (no treatment/placebo) for acute or postoperative paintreatment/management were included in this meta-analysis. Data was analyzed on 251 patients. Betweenthe lidocaine patch group and the control group, no significant difference was found for all three outcomes(all p40.05). For postoperative opioid consumption, mean difference (MD) was 8.2mg morphineequivalent (95% CI 28.68, 12.24). For postoperative pain intensity, MD was 9.1mm visual analogscale or equivalent (95% CI 23.31, 5.20). For length of hospital stay, MD was 0.2 days (95% CI 0.80,0.43).Conclusion:Application of a lidocaine patch may not be an effective adjunct for acute and postoperative painmanagement, in terms of pain intensity, opioid consumption and length of hospital stay.Limitations:The limitations were a small number of included studies, potential biases from some unblinded studies,clinical heterogeneity between studies, and incomplete reported data for adjunct analgesics.