{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:31:52Z","timestamp":1785407512784,"version":"3.56.0"},"reference-count":35,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: major open abdominal surgery remains associated with clinically important postoperative pain, delayed gastrointestinal recovery, opioid exposure, and prolonged length of stay. Intravenous lidocaine infusion (IVLI) has biologically plausible analgesic, anti-hyperalgesic, anti-inflammatory, and opioid-sparing effects, but prior evidence syntheses have often combined open and minimally invasive procedures. This systematic review evaluated evidence for perioperative IVLI in adult patients undergoing major open abdominal surgery. Methods: the review was structured according to PRISMA 2020. The final search was run on 15 January 2026 and covered PubMed\/MEDLINE, Embase, Cochrane CENTRAL, Scopus, Web of Science Core Collection, ClinicalTrials.gov, and WHO ICTRP from database inception to that date, without language restrictions at the search stage. Eligible studies enrolled adults undergoing elective open abdominal surgery and compared systemic IVLI with placebo, usual care, or active epidural analgesic comparators. Primary outcomes were postoperative opioid consumption and pain intensity. Secondary outcomes included gastrointestinal recovery, postoperative ileus, length of hospital stay, postoperative nausea and vomiting, inflammatory\/stress biomarkers, and adverse events. Results: ten randomized trials involving 658 participants were included. Placebo\/usual-care trials and active-comparator trials were synthesized separately because they address different clinical questions. IVLI generally reduced opioid consumption compared with placebo, with extractable effects including a 55.9 mg reduction in 72 h morphine use in one abdominal surgery trial and a 13.9 mg reduction in 24 h morphine use after radical prostatectomy. Gastrointestinal recovery favored IVLI in most placebo-controlled studies; for example, first flatus occurred 12.5 h earlier and first bowel movement 28.4 h earlier in one trial. Active-comparator trials suggested comparable early dynamic pain outcomes versus thoracic epidural analgesia in selected settings, although opioid consumption findings were less consistent. No serious lidocaine-related toxicity was reported, but the included trials were underpowered to detect rare local anesthetic systemic toxicity events and did not consistently capture subclinical neurologic symptoms such as perioral numbness or visual disturbance. Conclusions: in adult open abdominal surgery, perioperative IVLI may provide opioid-sparing and recovery benefits, particularly when infusion continues beyond the intraoperative period. However, the certainty of evidence remains limited.<\/jats:p>","DOI":"10.3390\/jcm15114068","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T11:57:44Z","timestamp":1779710264000},"page":"4068","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intravenous Lidocaine as an Adjunct for Postoperative Recovery After Open Abdominal Surgery: A Systematic Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0497-0405","authenticated-orcid":false,"given":"Calin","family":"Muntean","sequence":"first","affiliation":[{"name":"Department III-Functional Sciences, Medical Informatics and Biostatistics, \u201cVictor Babes\u201d University of Medicine and PharmacyTimi\u015foara, Eftimie Murgu Sq. No. 2, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melania Veronica","family":"Ardelean","sequence":"additional","affiliation":[{"name":"Department V, Internal Medicine I-Discipline of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timi\u015foara, Eftimie Murgu Sq. No 2, 300041 Timi\u015foara, Romania"},{"name":"Center of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8647-1003","authenticated-orcid":false,"given":"Vasile","family":"Gaborean","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Research Center, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timi\u015foara, Eftimie Murgu Sq. No. 2, 300041 Timi\u015foara, Romania"},{"name":"Department of Surgical Semiology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timi\u015foara, Eftimie Murgu Sq. No. 2, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6451-7461","authenticated-orcid":false,"given":"Ionut Flaviu","family":"Faur","sequence":"additional","affiliation":[{"name":"IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timi\u015foara, Romania"},{"name":"X Department of General Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timi\u015foara, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaviana Monique","family":"Faur","sequence":"additional","affiliation":[{"name":"Department of Doctoral Studies, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timi\u015foara, Eftimie Murgu Sq. No. 2, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razvan Constantin","family":"Vonica","sequence":"additional","affiliation":[{"name":"Preclinical Department, Discipline of Physiology, Faculty of Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550169 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3277-1198","authenticated-orcid":false,"given":"Catalin Vladut Ionut","family":"Feier","sequence":"additional","affiliation":[{"name":"Abdominal Surgery and Phlebology Research Center, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timi\u015foara, Romania"},{"name":"First Surgery Clinic, \u201cPius Brinzeu\u201d Clinical Emergency Hospital, 300723 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13643-020-01542-z","article-title":"PRISMA-S: An extension to the PRISMA statement for reporting literature searches in systematic reviews","volume":"10","author":"Rethlefsen","year":"2021","journal-title":"Syst. 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