Effectiveness of intravenous lidocaine in preventing postoperative nausea and vomiting in pediatric patients: A systematic review and meta-analysis

PONE-D-19-28099

Dear Dr. Nakajima,

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Journal requirements:

1. We noticed minor instances of text overlap with the following previous publication(s), which need to be addressed:

https://journals.lww.com/anesthesia-analgesia/Fulltext/2019/09000/Effectiveness_of_Magnesium_in_Preventing_Shivering.14.aspx?WT.mc_id=HPxADx20100319xMP

The text that needs to be addressed involves the Abstract and 'Assessment of quality of evidence' sections.

In your revision please ensure you cite all your sources (including your own works), and quote or rephrase any duplicated text outside the methods section. Further consideration is dependent on these concerns being addressed.

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'The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.'

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: Well presented and well researched. I'm not sure there is enough available data in the literature for this meta-analysis to further our understanding on this subject and as such I leave it to the editor to make the final decision on inclusion of this paper in this publication. From a science rigorous point of view, it's well done.

Reviewer #2: 1. POV/PONV in pediatric patients is a serious problem. Up to now, ondansetron seems to be more effective in treating and preventing PONV. The use of lidocaine may be an alternative way.

2. Although several RCT investigated the effect of lidocaine on PONV, the result is still unclear.

3. This Meta analysis provided a systematic review of presenting evidences. However, due to the low quality of these clinical trials, it's still uncertain if lidocaine dose work. This conclusion is helpful for clinical practice and further studies.

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Reviewer #1: Yes: Prof. Reny Segal

Reviewer #2: No