Key result
Intravenous lidocaine administered before induction decreased the median effective dose of propofol from 1.80 mg/kg to 1.56 mg/kg and significantly reduced total propofol consumption during painless gastroscopy.
Why the study?
Propofol sedation for gastroscope insertion can inhibit circulation and respiration, prompting evaluation of intravenous lidocaine to reduce propofol dose requirements.
Does intravenous lidocaine reduce the ED50 and requirement of propofol in adult patients undergoing painless gastroscopy?
RCT (n=90)
Double-blind
Computer-generated random number list at a 1:1 ratio
No
Does intravenous lidocaine reduce the ED50 and requirement of propofol in adult patients undergoing painless gastroscopy?
Absolute Event Rate: 1.56% vs 1.8%
Intravenous lidocaine at 1.5 mg/kg significantly reduces the required dose of propofol and decreases adverse hemodynamic and respiratory reactions during painless gastroscopy.
IV lidocaine lowers propofol ED50 and consumption in gastroscopy; supports adjunctive use to reduce sedation-related adverse events.
Backgroud: Gastroscope insertion is a distressing experience and propofol use for sedation can result in inhibition of circulation and respiration. Intravenous (IV) infusion of lidocaine has been shown to reduce propofol requirements during surgery.The goal of this study was to evaluate the impact of IV lidocaine on the median effective dose (ED50) of propofol and other outcomes after surgery. Method: Ninety adult patients undergoing analgesic gastroscopy were randomly divided into two groups (45 cases in each). The lidocaine group was slowly injected with 1% lidocaine at 1.5mg/kg while the saline group was given the same volume of saline before propofol induction. Motion and cough reaction were regarded as the judgment index of gastroscope implanted. The dose-response curves were made in the two groups when implanted gastroscope according to the formula of Y=Ymin+(Ymax-Ymin)/[1+10 log(ED50-X)*m ]. The primary outcome were the ED50 and requirement of propofol. Secondary outcomes were:intraoperative hemodynamic parameters,adverse reaction,awakening time,post-operative pain and fatigue. Results: Compared with the group S, the dose-response curve showing percentage of gastroscope implanted after propofol anesthesia in the L group shifted to the left. Intravenous infusion of lidocaine decreased the ED50 of propofol (group S 1.80mg/kg, group L 1.56mg/kg).Compared with group S, induction, additional requirement and total dose of propofol anesthesia, and incidence of bucking were significantly reduced in group L (P<0.05). Post-operative fatigue scores in group L were lower than that in group S (P < 0.05). Conclusion: Intravenous lidocaine could reduce the consumption of propofol anesthesia and reduce adverse reaction in patients undergoing painless gastroscopy. Trials registration: ChiCTR2000038542. Data of registration: Sep 23th, 2020.
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Shi et al. (2021) conducted an RCT in Patients undergoing painless gastroscopy (n=90). Intravenous lidocaine vs. Saline was evaluated on Median effective dose (ED50) of propofol. Intravenous lidocaine administered before induction decreased the median effective dose of propofol from 1.80 mg/kg to 1.56 mg/kg and significantly reduced total propofol consumption during painless gastroscopy.
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