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Abstract：
BACKGROUND: Intravenous lidocaine could be a potential alternative adjuvant to propofol-based sedation for gastroscopy in elderly patients. This study aimed to evaluate the effect of intravenous lidocaine on the median effective dose (ED50) of propofol induction dose in elderly patients undergoing painless gastroscopy.
METHODS: The study included 70 patients aged ≥ 60 years undergoing painless gastroscopy with 64 randomly assigned to either group L (2% lidocaine 1.5 mg/kg, n = 31) or group N (equal volume normal saline, n = 33). All patients received propofol induction following 0.1 μg/kg intravenous sufentanil. The Dixon \"up-and-down\" sequential method was used, with a 1.5 mg/kg initial induction dose of propofol followed by a 0.1 mg/kg sequential variable dose. The primary endpoint was the ED50 of the propofol induction dose. The total propofol dose, recovery time, adverse events, and local anesthetic intoxication reactions were also recorded.
RESULTS: The ED50 of propofol induction dose was 0.670 (95% confidence interval [CI] 0.216-0.827) mg/kg in group L and 1.118 (95% CI 0.803-1.232) mg/kg in group N. There was a statistically significant difference between the two groups (p < 0.001). The incidence of hypotension and propofol injection pain were lower in group L than in group N (p < 0.05). Furthermore, the orientation recovery time in group L was shorter compared to group N (p < 0.05). None of the participants in group L observed local anesthetic intoxication reactions after receiving lidocaine.
CONCLUSIONS: The administration of intravenous lidocaine to elderly patients undergoing painless gastroscopy resulted in a significant 40% reduction in the ED50 of propofol induction dose, which may be related to the decreased incidence of hypotension and injection pain, as well as the improved post-gastroscopy orientation recovery.
BACKGROUND: ChiCTR, ChiCTR2200065530. Registered on 08 November 2022.
METHODS: The study included 70 patients aged ≥ 60 years undergoing painless gastroscopy with 64 randomly assigned to either group L (2% lidocaine 1.5 mg/kg, n = 31) or group N (equal volume normal saline, n = 33). All patients received propofol induction following 0.1 μg/kg intravenous sufentanil. The Dixon \"up-and-down\" sequential method was used, with a 1.5 mg/kg initial induction dose of propofol followed by a 0.1 mg/kg sequential variable dose. The primary endpoint was the ED50 of the propofol induction dose. The total propofol dose, recovery time, adverse events, and local anesthetic intoxication reactions were also recorded.
RESULTS: The ED50 of propofol induction dose was 0.670 (95% confidence interval [CI] 0.216-0.827) mg/kg in group L and 1.118 (95% CI 0.803-1.232) mg/kg in group N. There was a statistically significant difference between the two groups (p < 0.001). The incidence of hypotension and propofol injection pain were lower in group L than in group N (p < 0.05). Furthermore, the orientation recovery time in group L was shorter compared to group N (p < 0.05). None of the participants in group L observed local anesthetic intoxication reactions after receiving lidocaine.
CONCLUSIONS: The administration of intravenous lidocaine to elderly patients undergoing painless gastroscopy resulted in a significant 40% reduction in the ED50 of propofol induction dose, which may be related to the decreased incidence of hypotension and injection pain, as well as the improved post-gastroscopy orientation recovery.
BACKGROUND: ChiCTR, ChiCTR2200065530. Registered on 08 November 2022.
摘要：
背景：静脉注射利多卡因可能是老年患者胃镜检查中基于丙泊酚的镇静剂的潜在替代佐剂。本研究旨在评估静脉注射利多卡因对老年患者无痛胃镜检查中丙泊酚诱导剂量的中位有效剂量（ED50）的影响。
方法：该研究包括70例年龄≥60岁接受无痛胃镜检查的患者，其中64例随机分配到L组（2％利多卡因1.5mg/kg，n=31）或N组（等容量生理盐水，n=33）。所有患者在0.1μg/kg静脉舒芬太尼后接受丙泊酚诱导。使用了狄克逊“上下”顺序法，丙泊酚初始诱导剂量为1.5mg/kg，随后为0.1mg/kg连续可变剂量。主要终点是异丙酚诱导剂量的ED50。异丙酚的总剂量,恢复时间,不良事件,还记录了局部麻醉剂中毒反应。
结果：L组丙泊酚诱导剂量的ED50为0.670（95％置信区间[CI]0.216-0.827）mg/kg，N组为1.118（95％CI0.803-1.232）mg/kg。两组之间有统计学差异（p<0.001）。L组低血压和丙泊酚注射痛发生率低于N组(p<0.05)。此外，与N组相比，L组的方向恢复时间更短（p<0.05）。L组的参与者在接受利多卡因后没有观察到局部麻醉剂中毒反应。
结论：接受无痛胃镜检查的老年患者静脉注射利多卡因导致丙泊酚诱导剂量的ED50显着降低40％，这可能与低血压和注射疼痛的发生率降低有关，以及改善胃镜检查后的方向恢复。
背景：ChiCTR，ChiCTR2200065530。2022年11月8日注册。
方法：该研究包括70例年龄≥60岁接受无痛胃镜检查的患者，其中64例随机分配到L组（2％利多卡因1.5mg/kg，n=31）或N组（等容量生理盐水，n=33）。所有患者在0.1μg/kg静脉舒芬太尼后接受丙泊酚诱导。使用了狄克逊“上下”顺序法，丙泊酚初始诱导剂量为1.5mg/kg，随后为0.1mg/kg连续可变剂量。主要终点是异丙酚诱导剂量的ED50。异丙酚的总剂量,恢复时间,不良事件,还记录了局部麻醉剂中毒反应。
结果：L组丙泊酚诱导剂量的ED50为0.670（95％置信区间[CI]0.216-0.827）mg/kg，N组为1.118（95％CI0.803-1.232）mg/kg。两组之间有统计学差异（p<0.001）。L组低血压和丙泊酚注射痛发生率低于N组(p<0.05)。此外，与N组相比，L组的方向恢复时间更短（p<0.05）。L组的参与者在接受利多卡因后没有观察到局部麻醉剂中毒反应。
结论：接受无痛胃镜检查的老年患者静脉注射利多卡因导致丙泊酚诱导剂量的ED50显着降低40％，这可能与低血压和注射疼痛的发生率降低有关，以及改善胃镜检查后的方向恢复。
背景：ChiCTR，ChiCTR2200065530。2022年11月8日注册。
