Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Anesthesia and Pediatrics, Cincinnati Children Hospital Medical Center, Cincinnati, OH, USA.
J Clin Pharm Ther. 2021 Jun;46(3):711-716. doi: 10.1111/jcpt.13335. Epub 2020 Dec 22.
Propofol provides a prominent sedation effect in gastroscopy. However, sedation with propofol alone during gastroscopy might result in circulatory and respiratory depression. This study aimed to test the hypothesis that the addition of intravenous lidocaine to propofol-based sedation could decrease the ED50 of propofol induction dose during gastroscopy in adult patients while the respiratory and haemodynamic stability were not compromised.
Patients undergoing gastroscopy were randomly enrolled into lidocaine + propofol (L + P) group or normal saline + propofol (NS + P) group. Subjects were initially administered intravenous bolus of 1.5 mg/kg lidocaine in L + P group or equivalent volume of 0.9% saline in NS + P group. Anaesthesia was then induced with a single bolus of 1.0 μg sufentanil followed by injection of propofol in all patients. The induction dose of propofol for each individual patient was determined by the protocol of Dixon "up-and-down" method for both groups. The primary end point was the ED50 of propofol induction dose.
Totally, 48 patients were enrolled and completed this study. Compared with the NS + P group, the ED50 of propofol induction dose was significantly reduced in the L + P group (2.01 mg/kg vs. 1.69 mg/kg) (U = 61.5, p < 0.001).
The addition of intravenous lidocaine significantly reduced the ED50 of propofol induction dose during gastroscopy in adult patients.
The present clinical trial was registered at http://www.chictr.org.cn/ (registration No. ChiCTR1900024025, 23 June 2019).
异丙酚在胃镜检查中提供显著的镇静作用。然而，单独使用异丙酚镇静可能导致循环和呼吸抑制。本研究旨在检验以下假设：在成人患者中，将静脉利多卡因加入异丙酚镇静中可降低胃镜检查中异丙酚诱导剂量的 ED50，同时不影响呼吸和血液动力学的稳定性。
接受胃镜检查的患者被随机纳入利多卡因+异丙酚（L+P）组或生理盐水+异丙酚（NS+P）组。在 L+P 组中，受试者首先给予 1.5mg/kg 静脉推注利多卡因，在 NS+P 组中给予等体积的 0.9%生理盐水。然后，所有患者均给予单次 1.0μg 舒芬太尼静脉推注，随后给予异丙酚注射。根据 Dixon“上下”法的方案确定两组中每个患者的异丙酚诱导剂量。主要终点是异丙酚诱导剂量的 ED50。
总共纳入 48 例患者完成了本研究。与 NS+P 组相比，L+P 组的异丙酚诱导剂量 ED50 显著降低（2.01mg/kg 比 1.69mg/kg）（U=61.5，p<0.001）。
静脉注射利多卡因可显著降低成人胃镜检查中异丙酚的诱导剂量 ED50。
本临床试验在中国临床试验注册中心注册（注册号 ChiCTR1900024025，2019 年 6 月 23 日）。
