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Randomized Controlled Trial
. 2021 Dec 1;21(1):299.
doi: 10.1186/s12871-021-01525-0.

Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study

Wenshui Yao  1 , Longxin Zhang  2 , Guolin Lu  1 , Jing Wang  1 , Li Zhang  1 , Yuping Wang  1 , Peihan Xiao  1 , Xiaofen Chen  1 , Chanjuan Chen  1 , Min Zhou  1
Affiliations
Randomized Controlled Trial

Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study

Wenshui Yao et al. BMC Anesthesiol. .

Abstract

Background: Propofol, a widely used sedative in endoscopic procedures, sometimes causes cardiopulmonary complications. Intravenous lidocaine can diminish visceral pain and decrease the dose of propofol. The purpose of this study was to assess the efficacy and safety of intravenous lidocaine in reducing propofol dosage during paediatric colonoscopy.

Methods: Forty children who underwent colonoscopy were divided into two groups. Lidocaine hydrochloride (1.5 mg/kg induction and 2 mg/kg/h maintenance) was given intravenously to the lidocaine group, and the same amount of saline was given to the control group after they received lidocaine induction. Propofol initial plasma concentration of 5 μg/mL was targeted, and the procedure was performed after the bispectral index value reached 55. The primary outcome was propofol requirement.

Results: The propofol requirement in the lidocaine group was decreased by 35.5% (128.6 ± 30.4 mg vs. 199.4 ± 57.6 mg; p < 0.001; 95%CI: - 100.60, - 41.02). The incidence of involuntary body movements was significantly lower in the lidocaine group (p = 0.028; OR = 0.17; 95%CI: 0.03, 0.92). The awakening time (p < 0.001; 95%CI: - 7.67, - 5.13) and recovery times (p < 0.001; 95%CI: - 7.45, - 4.35) were significantly lower in the lidocaine group. Pain was significantly less at 30 min and 60 min after the procedure in the lidocaine group (0 [0-4] vs. 3 [0-5], p < 0. 001; 0 [0-2] vs. 1 [0-3], p = 0.001). There was no difference in the incidence of bradycardia, hypotension, or hypoxia between the two groups.

Conclusions: For colonoscopy procedures in paediatric patients, intravenous lidocaine reduces the amount of propofol needed, provides better sedation and postprocedural pain management, as well as a reduction in recovery time.

Trial registration: The trial was registered on November 6, 2020 at China Clinical Trials Registration Center ( www.chictr.org.cn ) ref.: ChiCTR 2,000,039,706.

Keywords: Adverse events; Children; Colonoscopy; Lidocaine; Propofol.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT trial flow diagram
Fig. 2
Fig. 2
The changes of mean SBP in two groups. The basal SBP (BSBP), the lowest SBP in the procedure (LSBP), and the SBP after the procedure (ASBP). Data are shown as the mean ± SD. No significant difference was detected in blood pressure between the lidocaine group and control group (analysis of variance: P = 0.1)
Fig. 3
Fig. 3
The changes of mean HR in two groups. The basal HR (BHR), the lowest HR in the procedure (LHR), and the HR after the procedure (AHR). Data are shown as the mean ± SD. No significant difference was detected in heart rate between the lidocaine group and control group (analysis of variance: P = 0.354)
Fig. 4
Fig. 4
Pain scores after the procedure. Data are shown as the median (range)
See this image and copyright information in PMC

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