Procedure-specific effects of intravenous lidocaine in adult spine surgery: a systematic review and meta-analysis of randomized controlled trials.

Intravenous lidocaine reduced postoperative pain at 24 hours (9 trials, 655 patients; mean difference (MD), -0.83; 95% CI -1.36 to -0.30; p=0.002; I²=89%, 95% CI 81% to 93%; prediction interval, -2.69 to 1.02; moderate certainty) and opioid consumption (9 trials; MD, -11.64 mg intravenous morphine equivalents; 95% CI -16.14 to -7.14; p<0.001).

Baseline pain severity explained approximately 53% of between-study heterogeneity, whereas lidocaine infusion rate did not modify the treatment effect (p=0.97).

No significant effects were observed for postoperative nausea and vomiting or LOS.