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| 標題: | Impact of intravenous and topical lidocaine on clinical outcomes in patients receiving propofol for gastrointestinal endoscopic procedures: a meta-analysis of randomised controlled trials |
| 作者: | Hung, Kuo-Chuan
Yew, Ming
Lin, Yao-Tsung
Chen, Jen-Yin
Wang, Li-Kai
Chang, Ying-Jen
Chang, Yang-Pei
Lan, Kuo-Mao
Ho, Chun-Ning
Sun, Cheuk-Kwan |
| 貢獻者: | Chi Mei Hospital
Chia Nan University of Pharmacy & Science
Chia Nan University of Pharmacy & Science
Kaohsiung Medical University
Kaohsiung Municipal Ta-Tung Hospital
Kaohsiung Medical University
Kaohsiung Medical University Hospital
E-Da Hospital
I Shou University |
| 關鍵字: | double-blind
pharyngeal anesthesia
sedation
satisfaction
midazolam
efficacy
complications
colonoscopy
infusion
safety |
| 日期: | 2022 |
| 上傳時間: | 2023-12-11 13:57:19 (UTC+8) |
| 出版者: | ELSEVIER SCI LTD |
| 摘要: | Background: The efficacy of i.v. or topical lidocaine as an anaesthesia adjunct in improving clinical outcomes in patients receiving gastrointestinal endoscopic procedures under propofol sedation remains unclear. Methods: Electronic databases (MEDLINE, EMBASE, and Cochrane Library) were searched for RCTs comparing the clinical outcomes with or without lidocaine application (i.v. or topical) in patients receiving propofol for gastrointestinal endoscopic procedures from inception to 29 March 2021. The primary outcome was propofol dosage, while secondary outcomes included procedure time, recovery time, adverse events (e.g. oxygen desaturation), post-procedural pain, and levels of endoscopist and patient satisfaction. Results: Twelve trials (1707 patients) published between 2011 and 2020 demonstrated that addition of i.v. (n=7) or topical (n=5) lidocaine to propofol sedation decreased the level of post-procedural pain (standardised mean difference [SMD]=-0.47, 95% confidence interval [CI]: -0.8 to -0.14), risks of gag events (risk ratio [RR]=0.51, 95% CI: 0.35-0.75), and involuntary movement (RR=0.4, 95% CI: 0.16-0.96). Subgroup analysis demonstrated that only i.v. lidocaine reduced propofol dosage required for gastrointestinal endoscopic procedures (SMD=-0.83, 95% CI: -1.19 to -0.47), increased endoscopist satisfaction (SMD=0.75, 95% CI: 0.21-1.29), and shortened the recovery time (SMD=-0.83, 95% CI: -1.45 to -0.21). Intravenous or topical lidocaine did not affect the incidence of oxygen desaturation (RR=0.72, 95% CI: 0.41-1.24) or arterial hypotension (RR=0.6, 95% CI: 0.22-1.65) and procedure time (SMD=0.21, 95% CI: -0.09 to 0.51). Conclusion: This meta-analysis demonstrated that i.v. or topical lidocaine appears safe to use and may be of benefit for improving propofol sedation in patients undergoing gastrointestinal endoscopic procedures. Further large-scale trials are warranted to support our findings. |
| 關聯: | BRITISH JOURNAL OF ANAESTHESIA, v.128, n.CB2, pp.CC2, pp.-E130, |
| 顯示於類別: | [行政單位] 123
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