静脉注射利多卡因可减少基于丙泊酚的镇静用于胃肠内镜检查时引起的氧饱和度下降事件：一项前瞻性、随机、对照试验。

Intravenous lidocaine decreased oxygen-desaturation episodes induced by propofol-based sedation for gastrointestinal endoscopy procedures: a prospective, randomized, controlled trial.

作者信息

Qi Xiu-Ru, Qi Yu-Xuan, Zhang Ke, Hao Wen-Wen, An Li-Xin

机构信息

Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yongan Road, Beijing, Xicheng District, 100050, China.

Department of Anesthesiology, Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Anning, China.

出版信息

BMC Anesthesiol. 2025 Jan 11;25(1):27. doi: 10.1186/s12871-025-02890-w.

DOI:10.1186/s12871-025-02890-w

PMID:39799289

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11724489/

Abstract

BACKGROUND

As a popularly used analgesic adjuvant, intravenous (IV) lidocaine could reduce the consumption of propofol in painless gastrointestinal (GI) endoscopy. However, whether IV lidocaine could affect the incidence of oxygen-desaturation episodes (ODE) during painless GI endoscopy is still unknown. Therefore, we tested the hypothesis that IV lidocaine could decrease the incidence of propofol-induced ODE and involuntary movements in patients during GI endoscopy.

METHODS

Three hundred twenty-two patients scheduled for GI endoscopy were randomly divided into lidocaine group and control group. After midazolam and sufentanil injection, a bolus of 1.5 mg/kg lidocaine was given and followed by continuous infusion of 4 mg/kg/h in lidocaine group, whereas the same volumes of saline solution in control group. Then, propofol was titrated to produce unconsciousness. The primary outcome was the incidence of ODE during the procedure. The secondary outcomes were the incidence of different degree of hypoxia and corresponding treatments and the involuntary body movements.

RESULTS

A total of 300 patients were finally included in the analysis, 147 patients in lidocaine group and 153 in control group. The incidence of ODE was 22% in lidocaine group and 39% in control group (OR:0.052; 95%CI: 0.284-0.889; P = 0.018). IV lidocaine also improved the occurrence of different degree of hypoxia (P = 0.017) and needed few treatments (P = 0.028). The incidence of involuntary body movements (14% vs 26%, P = 0.013) and adverse circulatory events was decreased by IV lidocaine.

CONCLUSIONS

IV lidocaine adjuvant to propofol-based sedation could reduce the incidence of oxygen-desaturation episodes and involuntary body movements, with fewer adverse circulatory events.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2100053818. Registered on 30 November 2021.

摘要

背景

作为一种常用的镇痛辅助药物，静脉注射利多卡因可减少无痛胃肠镜检查中丙泊酚的用量。然而，静脉注射利多卡因是否会影响无痛胃肠镜检查期间氧饱和度下降事件（ODE）的发生率仍不清楚。因此，我们检验了以下假设：静脉注射利多卡因可降低胃肠镜检查期间丙泊酚诱导的ODE和患者不自主运动的发生率。

方法

322例计划进行胃肠镜检查的患者被随机分为利多卡因组和对照组。在注射咪达唑仑和舒芬太尼后，利多卡因组给予1.5mg/kg的负荷剂量，随后以4mg/（kg·h）的速度持续输注，而对照组输注相同体积的生理盐水。然后，滴定丙泊酚以诱导意识丧失。主要结局是检查过程中ODE的发生率。次要结局是不同程度缺氧的发生率、相应治疗措施以及不自主身体运动情况。

结果

最终共有300例患者纳入分析，利多卡因组147例，对照组153例。利多卡因组ODE的发生率为22%，对照组为39%（OR：0.052；95%CI：0.284 - 0.889；P = 0.018）。静脉注射利多卡因还改善了不同程度缺氧的发生情况（P = 0.017），且所需治疗较少（P = 0.028）。静脉注射利多卡因降低了不自主身体运动的发生率（14%对26%，P = 0.013）以及不良循环事件的发生率。