Efficacy and safety of intravenous lidocaine in propofol-based sedation for ERCP procedures: a prospective, randomized, double-blinded, controlled trial

Liu, Jing; Li, Xiaoping; Peng, Liping; Ji, Rui; Liu, Chao; Li, Yanqing

doi:10.1016/j.gie.2020.02.050

Cited by 25 publications

(37 citation statements)

References 27 publications

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“…In addition, lidocaine can directly stimulate opiate receptors while suppressing polysynaptic reflexes in the spinal dorsal horn [ 20 , 21 ]. The pain scores in this study did not differ after intravenous lidocaine, which was different from those in previous research by Forster [ 12 ] and Liu [ 22 ]. A possible explanation for this observation might be that the continuously infused dose of lidocaine was larger in the two previous studies.…”

Section: Discussioncontrasting

confidence: 99%

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Effect of intravenous lidocaine on propofol consumption in elderly patients undergoing colonoscopy: a double-blinded, randomized, controlled trial

Zhuang

2022

BMC Anesthesiol

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Background Elderly patients undergoing colonoscopy with propofol as sedation are prone to respiratory or cardiovascular complications. Intravenous lidocaine has analgesic efficacy and reduces propofol consumption during surgery. Here, the effect of intravenous lidocaine on propofol consumption was evaluated in elderly patients undergoing colonoscopy. Methods Patients were randomly allocated to receive intravenous lidocaine (1.5 mg/kg bolus dose, followed by a 2 mg/kg/h continuous infusion during the procedure; Group L) or a placebo (saline; Group N). During the procedure, sedation was achieved by propofol. The following outcomes were recorded: total propofol consumption; time to loss of consciousness; number of airway modifications; time to the first airway intervention; incidence of sedation-related events; pain score after awakening; endoscopists’ and patients’ satisfaction scores; memory level of the procedure; and adverse events within 24 h postoperatively. Results Compared with Group N, propofol consumption was reduced by 13.2% in Group L (100.30 ± 25.29 mg vs. 115.58 ± 27.52 mg, respectively, p = 0.008). Kaplan–Meier curves showed that the median time to the loss of consciousness episode was shorter in Group L than in Group N (40 s vs. 55 s, respectively, log rank p < 0.0001). The number of airway modifications, time to the first airway intervention, incidence of sedation-related events, time to awakening, pain score after awakening, endoscopists’ and patients’ satisfaction scores, memory level of the procedure and adverse events within 24 h postoperatively did not differ between the two groups (p > 0.05). Conclusions Intravenous lidocaine can reduce propofol consumption in elderly patients undergoing colonoscopy, with quicker time to loss of consciousness. Trial registration The clinical trial was registered at (12/01/2021, ChiCTR2100042001).

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Section: Discussioncontrasting

confidence: 99%

“…Kaplan–Meier and log-rank test analyses showed that the median duration time of consciousness loss in Group L was decreased by approximately one-third, which was similar to that in the research by Liu [ 22 ] and Li [ 23 ]. Lidocaine combined with propofol shortened the duration of consciousness loss.…”

Section: Discussionsupporting

confidence: 85%

Effect of intravenous lidocaine on propofol consumption in elderly patients undergoing colonoscopy: a double-blinded, randomized, controlled trial

Zhuang

2022

BMC Anesthesiol

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“…21,22 The clinical effect of intravenous lidocaine is particularly significant in abdominal surgery. 23 In the present study, intravenous lidocaine had a similar effect on hemodynamic parameters to dexmedetomidine. The incidences of respiratory depression (33.3%) and choking (43.3%) were lowest with intravenous lidocaine, while the incidence of tube intolerance agitation was the highest (73.3%).…”

Section: Discussionsupporting

confidence: 66%

Effects of different sedatives/analgesics on stress responses in patients undergoing craniotomy and bone flap decompression

Guo

Yang

et al. 2021

J Int Med Res

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Objective To explore the effects of sedation and analgesia with dexmedetomidine and other drugs on the stress response in patients with cerebral hemorrhage after craniotomy hematoma removal and bone flap decompression and insertion of an indwelling endotracheal catheter. Methods A total of 180 patients with cerebral hemorrhage with consciousness disturbance who underwent emergency surgery were included in this study. They were divided into six groups treated with propofol, dexmedetomidine, lidocaine, sufentanil, dezocine, and remifentanil, respectively. Intravenous medication was given after recovery of spontaneous respiration, and stress responses were compared among the group. Results Serum concentrations of norepinephrine, epinephrine, and cortisol and systolic blood pressure were significantly correlated with drug treatment. Serum norepinephrine concentrations differed significantly among the groups, except between the sufentanil and propofol groups. There were significant differences in serum epinephrine concentrations among all groups, and significant differences in serum cortisol concentrations among all groups, except the propofol, dexmedetomidine, and lidocaine groups. Conclusion Dexmedetomidine can reduce the stress response in patients with intracerebral hemorrhage undergoing emergency craniotomy and bone flap decompression, and can reduce adverse events from an indwelling endotracheal catheter 3 hours post-operation.

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“…In recent years, intravenous lidocaine has been widely used as a perioperative analgesic agent 16 , especially in the management of acute pain in Scottish hospitals 30 . According to previous reports [31][32][33] , the dosage of intravenous lidocaine injection in this study was selected as 1.5mg/kg, resulting in signi cant propofol-sparing effect.…”

Section: Disscusionmentioning

confidence: 99%

Estimation of the ED50 of propofol with intravenous lidocaine for inserting gastroscope without body movement in adult patients: A randomized, controlled study

Sun

et al. 2022

Preprint

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BackgroundCirculatory and respiratory depression are common problems that occur in propofol alone sedation during gastroscopy. As a widely used analgesic adjuvant, intravenous lidocaine can reduce the consumption of propofol during ERCP or colonoscopy. However, it is still unknown the ED50 of propofol when combined with lidocaine intravenously. This study aimed to estimate the ED50 of propofol, when combined with lidocaine as an adjuvant, for inserting gastrointestinal endoscope successfully.Methods59 patients undergoing gastroscopy or gastrointestinal (GI) endoscopy were randomly divided into control group (Group C, normal saline + propofol) or lidocaine group (Group L, lidocaine + propofol). Patients were initially injected a bolus of 1.5 mg/kg lidocaine in Group L, whereas equivalent volume of 0.9% saline in Group C. Anaesthesia was then induced with a single bolus of propofol in all subjects. The induction dose of propofol was determined by the modified Dixon's up-and-down method, and the initial dose was 1.5mg/kg in both groups. The primary outcome was the ED50 of propofol induction dose. The secondary outcomes were the first time to add propofol, the movements and adverse events.ResultsTotally, 59 patients were enrolled and completed this study. Compared with the Group C, the ED50 of propofol induction dose was significantly reduced in the Group L (1.68±0.11 mg/kg vs. 1.88 ± 0.13 mg/kg) (P = 0.002). There was no statistical difference in induction time (P = 0.115) and the first propofol bolus time (P = 0.655) between the two groups.ConclusionThe estimated ED50 of propofol induction dose with intravenous lidocaine for successful endoscope insertion in adult patients, was significantly reduced compared with the saline group.Trial registrationChinese Clinical Trial Registry, No: ChiCTR2200059450. Registered on 29 April 2022. Prospective registration. http://www.chictr.org.cn.

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Efficacy and safety of intravenous lidocaine in propofol-based sedation for ERCP procedures: a prospective, randomized, double-blinded, controlled trial

Cited by 25 publications

References 27 publications

Effect of intravenous lidocaine on propofol consumption in elderly patients undergoing colonoscopy: a double-blinded, randomized, controlled trial

Effect of intravenous lidocaine on propofol consumption in elderly patients undergoing colonoscopy: a double-blinded, randomized, controlled trial

Effects of different sedatives/analgesics on stress responses in patients undergoing craniotomy and bone flap decompression

Estimation of the ED50 of propofol with intravenous lidocaine for inserting gastroscope without body movement in adult patients: A randomized, controlled study

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