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

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...

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Autores principales:	Wenshui Yao, Longxin Zhang, Guolin Lu, Jing Wang, Li Zhang, Yuping Wang, Peihan Xiao, Xiaofen Chen, Chanjuan Chen, Min Zhou
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Lidocaine Propofol Colonoscopy Children Adverse events Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/8244a72c10924760a62f0abbbc730882
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spelling	oai:doaj.org-article:8244a72c10924760a62f0abbbc7308822021-12-05T12:07:59ZUse of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study10.1186/s12871-021-01525-01471-2253https://doaj.org/article/8244a72c10924760a62f0abbbc7308822021-12-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01525-0https://doaj.org/toc/1471-2253Abstract 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.Wenshui YaoLongxin ZhangGuolin LuJing WangLi ZhangYuping WangPeihan XiaoXiaofen ChenChanjuan ChenMin ZhouBMCarticleLidocainePropofolColonoscopyChildrenAdverse eventsAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Lidocaine Propofol Colonoscopy Children Adverse events Anesthesiology RD78.3-87.3
spellingShingle	Lidocaine Propofol Colonoscopy Children Adverse events Anesthesiology RD78.3-87.3 Wenshui Yao Longxin Zhang Guolin Lu Jing Wang Li Zhang Yuping Wang Peihan Xiao Xiaofen Chen Chanjuan Chen Min Zhou Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study
description	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.
format	article
author	Wenshui Yao Longxin Zhang Guolin Lu Jing Wang Li Zhang Yuping Wang Peihan Xiao Xiaofen Chen Chanjuan Chen Min Zhou
author_facet	Wenshui Yao Longxin Zhang Guolin Lu Jing Wang Li Zhang Yuping Wang Peihan Xiao Xiaofen Chen Chanjuan Chen Min Zhou
author_sort	Wenshui Yao
title	Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study
title_short	Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study
title_full	Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study
title_fullStr	Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study
title_full_unstemmed	Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study
title_sort	use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/8244a72c10924760a62f0abbbc730882
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Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study

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