一项随机对照试验表明，静脉注射利多卡因可降低老年体弱患者ERCP手术的严重不良事件发生率。
Intravenous lidocaine decreased the incidence of SRAEs for ERCP procedures in elderly frailty patients, a randomized controlled trial.
作者信息
Gao Hao, Yin Zhi-Yu, Hao Li-Xiao, Wang Jian, Cai Hao-Liang, Guo Jun, Huang Xiao-Fan, Yong Yue, Wang Yong-Qiang, Chen Wen-Ting, Song Jian-Gang
机构信息
Department of Anesthesiology, Shuguang Hospital Afliated With Shanghai University of Traditional Chinese Medicine, No. 528 Zhangheng Road, Shanghai, 201203, China.
Digestive Endoscopy Center, Shuguang Hospital Afliated With Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
出版信息
Surg Endosc. 2025 Mar;39(3):1635-1642. doi: 10.1007/s00464-024-11451-0. Epub 2025 Jan 8.
OBJECTIVES
Elderly frailty patients are at particular risk of sedation-related adverse events (SRAEs) during sedation. This study aimed to assess whether intravenous lidocaine could reduce the incidence of SRAEs in elderly frailty patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).
METHODS
A total of 210 elderly frailty patients scheduled for ERCP were randomly divided into two groups: lidocaine and control. Patients in the lidocaine group received intravenous lidocaine (1.0 mg/kg) before anesthesia induction, followed by continuous intravenous infusion (2.0 mg/kg/h) during ERCP. The control group received an equal volume of saline solution. The primary endpoint was the composite incidence of SRAEs during ERCP. Secondary endpoints were propofol consumption, VAS score, endoscopists' and patients' satisfaction scores and lidocaine-related adverse events and so on.
RESULTS
The composite incidence of SRAEs in the lidocaine group was significantly lower than in the control group (41.05% vs. 21.86%, p < 0.05). The propofol requirement (436.11 ± 118.90, 388.54 ± 149.65. p < 0.001) and VAS score of patients (3.02 ± 1.07, 2.54 ± 1.10. p < 0.05) in the lidocaine group were significantly lower than those in the control group. The endoscopists' satisfaction scores (7.77 ± 1.12, 8.23 ± 1.10. p < 0.05) and patients' satisfaction scores (8.53 ± 0.95, 8.98 ± 0.86. p < 0.05) in lidocaine group were significantly higher than those in the control group.
CONCLUSIONS
Intravenous lidocaine can significantly decrease the incidence of SRAEs for ERCP procedures in elderly frailty patients, with no increase in lidocaine or other related adverse events.
TRIAL REGISTRATION
Chinese Clinical Trial Registry (Trial ID: ChiCTR2300067796, https://www.chictr.org.cn/showproj.html?proj=185763 ).
目的
老年体弱患者在镇静期间发生与镇静相关的不良事件（SRAEs）的风险尤其高。本研究旨在评估静脉注射利多卡因是否能降低接受内镜逆行胰胆管造影（ERCP）的老年体弱患者SRAEs的发生率。
方法
总共210例计划进行ERCP的老年体弱患者被随机分为两组：利多卡因组和对照组。利多卡因组患者在麻醉诱导前静脉注射利多卡因（1.0mg/kg），随后在ERCP期间持续静脉输注（2.0mg/kg/h）。对照组接受等量的生理盐水溶液。主要终点是ERCP期间SRAEs的综合发生率。次要终点是丙泊酚用量、视觉模拟评分（VAS）、内镜医师和患者的满意度评分以及利多卡因相关不良事件等。
结果
利多卡因组SRAEs的综合发生率显著低于对照组（41.05%对21.86%，p<0.05）。利多卡因组患者的丙泊酚需求量（436.11±118.90，388.54±149.65，p<0.001）和VAS评分（3.02±1.07，2.54±1.10，p<0.05）显著低于对照组。利多卡因组内镜医师的满意度评分（7.77±1.12，8.23±1.10，p<0.05）和患者的满意度评分（8.53±0.95，8.98±0.86，p<0.05）显著高于对照组。
结论
静脉注射利多卡因可显著降低老年体弱患者ERCP手术中SRAEs的发生率，且不会增加利多卡因或其他相关不良事件的发生。
试验注册
中国临床试验注册中心（试验注册号：ChiCTR2300067796，https://www.chictr.org.cn/showproj.html?proj=185763 ）
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