持续静脉应用利多卡因对老年患者术后谵妄影响的Meta分析OA

Objective To systematically evaluate the effect of continuous intravenous application of lidocaine on the incidence of postoperative delirium.Methods Computerized searches were conducted in CNKI,Wanfang Data,PubMed,Embase,Cochrane Li-brary,and the Chinese Medical Association Database,and the search period ended in December 2025.English search terms included"Lidocaine","Lidocaine Hydrocarbonate",or"Xyloneural",combined with"Postoperative delirium","delirium after surgery","delirium after surgical intervention",or"delirium after surgical repair",etc.A combination of subject terms and free-text words was used,supplemented by manual screening of the reference lists of included studies.Two researchers independently performed the litera-ture screening,data extraction,and quality assessment.Statistical analysis was conducted using Review Manager 5.3 and Stata 16.0.Results A total of 6 randomized controlled trials were included,involving 530 patients.Meta-analysis showed that compared with the control group,the lidocaine group had a significantly lower incidence of postoperative delirium(RR=0.35,95%CI:0.24-0.52,P<0.001).Serum levels of IL-6(MD=-13.94,95%CI:-15.86 to-12.02,P<0.001)and TNF-α(MD=-11.00,95%CI:-16.24 to-5.75,P<0.001)on postoperative day 1 were also significantly reduced.Conclusions Continuous perioperative intravenous ad-ministration of lidocaine can reduce the risk of postoperative delirium and decrease serum concentrations of IL-6 and TNF-α on postop-erative day.