Xiao Fei, Xu Lu-Qi, Yan Hai-Ya, Zhou Si, Fan Jia-Ming, Liu Lin
Department of Anesthesiology, The Affiliated Women and Children's Hospital of Ningbo University, Ningbo, People's Republic of China.
Department of Anesthesiology, Jiaxing Women and Children's Hospital, Wenzhou Medical University, Jiaxing, People's Republic of China.
Drug Des Devel Ther. 2025 Jul 29;19:6461-6468. doi: 10.2147/DDDT.S534226. eCollection 2025.
Lidocaine was reported to stabilize the hemodynamic status and reduce the incidence of postinduction hypotension in elderly patients. However, the optimal dose of lidocaine as an adjuvant to propofol-remifentanil during endotracheal intubation in elderly female patients remains uncertain. In this study, we aimed to determine the optimal dose of lidocaine as an adjuvant for propofol-remifentanil in elderly female patients.
Two hundred and forty patients were randomly assigned to one of three groups in a ratio of 1:1:1, each receiving a different dosage of lidocaine: 0.5 mg/kg, 1.0 mg/kg, or 1.5 mg/kg, with propofol-remifentanil for endotracheal intubation. Patients' hemodynamic parameters were continuously monitored 10 minutes after the induction of anesthesia. Hypotension, defined as a mean arterial pressure <70% of the baseline value and/or <65 mm Hg, and treated with norepinephrine 4 μg, repeated as necessary. Norepinephrine consumption (primary outcome), mean arterial pressure, heart rate, and propofol consumption were recorded.
The incidence of hypotension was 51.4% (37/72), 13.0% (9/69), and 13.8% (9/65) in Groups 0.5, 1.0, and 1.5, respectively. The median (25th and 75th quartiles) consumption of norepinephrine was 4 (0-4) μg, 0 (0-0) μg, and 0 (0-0) μg across the groups, respectively; there was a significant difference among the groups (p = 0.0006). The incidence of hypertension was 15.7% (11/72), 5.8% (4/69), and 6.2% (4/65) across the groups, respectively.
In summary, under the conditions of this study, we propose that 1.0 mg/kg lidocaine may be considered as an optimal dose when used as an adjuvant to propofol-remifentanil for endotracheal intubation.
Chinese Clinical Trial Registry number: ChiCTR2400092990 https://www.chictr.org.cn/bin/project/edit?pid=231367.
据报道，利多卡因可稳定血流动力学状态并降低老年患者诱导后低血压的发生率。然而，在老年女性患者气管插管期间，利多卡因作为丙泊酚-瑞芬太尼辅助用药的最佳剂量仍不确定。在本研究中，我们旨在确定老年女性患者中利多卡因作为丙泊酚-瑞芬太尼辅助用药的最佳剂量。
240例患者按1:1:1的比例随机分为三组，每组接受不同剂量的利多卡因：0.5mg/kg、1.0mg/kg或1.5mg/kg，并使用丙泊酚-瑞芬太尼进行气管插管。麻醉诱导10分钟后持续监测患者的血流动力学参数。低血压定义为平均动脉压<基线值的70%和/或<65mmHg，使用去甲肾上腺素4μg进行治疗，必要时重复使用。记录去甲肾上腺素消耗量（主要结局）、平均动脉压、心率和丙泊酚消耗量。
0.5mg/kg组、1.0mg/kg组和1.5mg/kg组的低血压发生率分别为51.4%（37/72）、13.0%（9/69）和13.8%（9/65）。各组去甲肾上腺素的消耗量中位数（第25和第75四分位数）分别为4（0-4）μg、0（0-0）μg和0（0-0）μg；各组间差异有统计学意义（p=0.0006）。各组高血压发生率分别为15.7%（11/72）、5.8%（4/69）和6.2%（4/65）。
总之，在本研究条件下，我们建议1.0mg/kg利多卡因作为丙泊酚-瑞芬太尼辅助气管插管用药时可考虑为最佳剂量。
中国临床试验注册中心编号：ChiCTR2400092990 https://www.chictr.org.cn/bin/project/edit?pid=231367
