Abstract
BackgroundPropofol, 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.MethodsForty 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.ResultsThe 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.ConclusionsFor 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 registrationThe trial was registered on November 6, 2020 at China Clinical Trials Registration Center (www.chictr.org.cn) ref.: ChiCTR 2,000,039,706.
Highlights
Endoscopy is a common evaluation method for a variety of intestinal disorders in children
Sedation time, and adverse events Intravenous lidocaine reduced the dose of propofol needed by 35.5% (p < 0.001; 95%Confidence interval (CI): −100.60, − 41.02) in paediatric patients undergoing colonoscopy
Awakening (p < 0.001; 95%CI: − 7.67, − 5.13) and recovery times (p < 0.001; 95%CI: − 7.45, − 4.35) in the lidocaine group were significantly shorter than in the control group
Summary
Endoscopy is a common evaluation method for a variety of intestinal disorders in children. Additional personnel may be necessary for procedures involving younger children in order to restrain them, as well as deeply sedate them [2]. Such a level of sedation might increase the risk of airway obstruction and unexpected complications, eventually leading to the need for general anaesthesia [3, 4]. One of the most common sedatives used in outpatient examinations is propofol, due to its rapid effect and short half-life. It can cause adverse cardiopulmonary reactions [5]. The purpose of this study was to assess the efficacy and safety of intravenous lidocaine in reducing propofol dosage during paediatric colonoscopy
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