Efficacy and safety of intraperitoneal lidocaine in patients undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized clinical trials.

Sajid Hussain Altaf Hussain, Howaida Shaker Saati, Marya Ahsan, Razan Orfali, Farhana Ayub, Adnan Jehangir

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Review in Irish journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Sajid Hussain Altaf HussainDepartment of Basic Medical Sciences, College of Medicine, Majmaah University, 11952, Majmaah, Saudi Arabia. d.hussain@mu.edu.sa.

Howaida Shaker SaatiCollege of Nursing - Jeddah Branch, Jeddah, Saudi Arabia.

Marya AhsanDepartment of Pharmacology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia.

Razan OrfaliDepartment of Pharmacology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia.

Farhana AyubBio-Medical Sciences Department, College of Medicine, King Faisal University, Al Ahsa, Saudi Arabia.

Adnan JehangirBio-Medical Sciences Department, College of Medicine, King Faisal University, Al Ahsa, Saudi Arabia.

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6 · The paper itself

Abstract

backgroundPostoperative pain remains a significant clinical challenge following laparoscopic cholecystectomy (LC), with up to 80% of patients experiencing moderate to severe pain. Intraperitoneal (IP) lidocaine has emerged as a promising opioid-sparing analgesic technique, though evidence regarding its efficacy remains inconsistent.

aimsTo critically evaluate the analgesic efficacy and safety of intraperitoneal lidocaine compared with saline and intravenous lidocaine in patients undergoing laparoscopic cholecystectomy.

methodsWe included randomized controlled trials comparing IP lidocaine with saline or intravenous (IV) lidocaine in patients undergoing LC. We searched PubMed, Scopus, Web of Science, and Cochrane Library from inception to November 2025. Primary outcomes included early (0-8 h), late (24 h), and shoulder tip postoperative pain scores. Secondary outcomes comprised opioid consumption, hospital length of stay, and postoperative nausea and vomiting (PONV) incidence. Random-effects models were used for all analyses, with subgroup analyses based on lidocaine dosage.

resultsEight randomized controlled trials involving 532 patients were included. Compared to saline, IP lidocaine significantly reduced early postoperative pain (MD = -1.06, 95% CI: -1.78 to -0.34, p = 0.004), late pain at 24 h (MD = -0.60, 95% CI: -1.00 to -0.21, p = 0.003), and shoulder tip pain (MD = -1.04, 95% CI: -1.82 to -0.26, p = 0.009). Total opioid consumption was significantly reduced (SMD = -3.68, 95% CI: -6.65 to -0.72, p = 0.01). No significant differences were observed in hospital length of stay or PONV incidence. When compared to IV lidocaine, IP administration showed no significant difference in early pain relief, but IV lidocaine demonstrated superior late pain control (MD = 1.99, 95% CI: 1.59 to 2.40, p < 0.00001) and longer time to first analgesic request (MD = -73.30 min, 95% CI: -98.65 to -47.95, p < 0.00001).

conclusionIP lidocaine provides significant pain relief and reduces opioid consumption following LC compared to placebo. While it offers comparable early analgesic effects to IV lidocaine, systemic administration provides superior sustained pain relief. IP lidocaine represents a safe, cost-effective adjunct for multimodal analgesia in LC, particularly for addressing shoulder tip pain.

Indexed as

Intraperitoneal lidocaineLaparoscopic cholecystectomyOpioid-sparing analgesiaPostoperative pain

Identifiers

PMID42635884

DOI10.1177/0300060513505493

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.