{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:15:48Z","timestamp":1785521748925,"version":"3.56.0"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020265","name":"Stan Perron Charitable Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Lidocaine is widely used in pediatric anesthesia for airway topicalization to modulate undesirable airway and circulatory reflexes, yet its effectiveness remains unclear. Therefore, we aimed to perform a meta\u2010analysis evaluating the impact of topical lidocaine on respiratory adverse events in children undergoing airway management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, and Cochrane databases were systematically searched for studies comparing topical lidocaine with placebo, no intervention, or intravenous lidocaine for pediatric airway management. Statistical analysis was performed using R (version 4.4.1). Odds ratios (ORs) were used for binary outcomes and mean differences for continuous outcomes, with 95% confidence intervals (CIs) computed using a random\u2010effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen randomized controlled trials comprising 1937 pediatric patients were included, of whom 917 (47%) received airway topicalization. In those receiving topical lidocaine, there was a significant reduction in the incidence of laryngospasm (OR 0.50; 95% CI 0.27 to 0.95;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033), desaturation (OR 0.49; 95% CI 0.25 to 0.98;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043), and sore throat (OR 0.31; 95% CI 0.16 to 0.58;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, no significant differences were observed for bronchospasm (OR 0.50; 95% CI 0.11 to 2.35;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.382), cough (OR 0.56; 95% CI 0.28 to 1.11;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.099), severe cough (OR 1.30; 95% CI 0.18 to 9.51;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.793), hoarseness (OR 1.41; 95% CI 0.17 to 11.96;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.754), vomiting (OR 1.95; 95% CI 0.47 to 7.99;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.355), and heart rate (beats\/min) (MD 0.08; 95% CI \u22126.31 to 6.47;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.98).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that topical lidocaine may reduce the incidence of undesirable airway reflexes such as laryngospasm, desaturation, and sore throat in children undergoing airway management. However, its benefit for other perioperative respiratory adverse events requires further investigation, especially in high\u2010risk populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO registration number: CRD42024614863<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pan.70077","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T12:15:37Z","timestamp":1762863337000},"page":"151-163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Topical Lidocaine During Airway Manipulation in Pediatric Anesthesia: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8924-9171","authenticated-orcid":false,"given":"Elizabet Taylor Pimenta","family":"Weba","sequence":"first","affiliation":[{"name":"State University of Maranh\u00e3o Tocantine Region  Imperatriz Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5068-1647","authenticated-orcid":false,"given":"Gabriel Soares","family":"de Sousa","sequence":"additional","affiliation":[{"name":"Discipline of Anaesthesiology, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Instituto da Crian\u00e7a e do Adolescente, Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Servi\u00e7os M\u00e9dicos de Anestesia, Hospital S\u00edrio\u2010Liban\u00eas  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6148-2283","authenticated-orcid":false,"given":"Alexandros P\u00e1ris","family":"de Mesquita Ip\u00e1cio","sequence":"additional","affiliation":[{"name":"State University of Maranh\u00e3o Tocantine Region  Imperatriz Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1900-9432","authenticated-orcid":false,"given":"Christian Ken","family":"Fukunaga","sequence":"additional","affiliation":[{"name":"FMABC University Center  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3290-9546","authenticated-orcid":false,"given":"Rafael Andrade Sampaio","family":"Silva","sequence":"additional","affiliation":[{"name":"Bahiana School of Medicine and Public Health  Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4455-7448","authenticated-orcid":false,"given":"Marco Antonio Figueiredo","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Petr\u00f3polis Medical School  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7807-2201","authenticated-orcid":false,"given":"Rafaela Machado","family":"Filardi","sequence":"additional","affiliation":[{"name":"Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-1077","authenticated-orcid":false,"given":"Carolina Magalh\u00e3es","family":"Costa","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation, Hospital S\u00edrio\u2010Liban\u00eas  S\u00e3o Paulo Brazil"},{"name":"Hepatology and Liver Transplantation, A. 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