Continuous Infusion of Lidocaine in Pediatric Colonoscopy: A Randomized Placebo-Controlled Study

Background: To investigate the effect of intravenous lidocaine on perioperative propofol and sufentanil dosage, pulse oxygen saturation, postoperative pain score and recovery time during pediatric colonoscopy.Methods: We designed a randomized placebo-controlled study and enrolled 80 children aged from 3 to 10 years old who were received colonoscopy. After titration of propofol to achieve unconsciousness, patients were given intravenous lidocaine (1.5 mg kg-1 then 2 mg kg-1 h-1) or the same volume of saline. Sedation was standardized and combined propofol with sufentanil. The primary outcome variables were intraoperative propofol and sufentanil requirements and number of oxygen desaturation episodes. Secondary outcome variables were recovery time after colonoscopy and post-colonoscopy pain.Results: Lidocaine infusion resulted in a significant reduction in propofol requirements: mean (SD) 44.3 (9.9) vs 74.5 (12.0) mg, respectively; P<0.001) and sufentanil requirements: mean (SD) 1.5 (0.3) vs 2.6 (0.6) ug respectively; p<0.001). The number of subjects who experienced oxygen desaturation below 95% in the lidocaine group was also significantly less than that in the control group: 2 vs 8 (P=0.04). The mean (SD) recovery time was significantly shorter in lidocaine group: 19.2 (2.6) vs 13.3 (2.6) min respectively; p<0.001). There were no significant difference regarding post-colonoscopy pain.Conclusions: Continuous infusion of lidocaine resulted in reduction of propofol and sufentanil dose, recovery time and risk of hypoxemia during pediatric colonoscopy.Trial Registration: Chinese Clinical Trials Registry, ChiCTR2000028927, 8 January, 2020, prospectively registered.