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

Summary

In a randomized controlled trial of 300 patients undergoing GI endoscopy with propofol-based sedation, IV lidocaine (1.5 mg/kg bolus + 4 mg/kg/h infusion) reduced oxygen-desaturation episodes (22% vs 39%, p=0.018) and involuntary movements (14% vs 26%, p=0.013), with fewer circulatory adverse events.

Key Findings

• Oxygen-desaturation episodes decreased from 39% (control) to 22% with IV lidocaine (p=0.018).
• Involuntary body movements reduced (14% vs 26%, p=0.013) and fewer circulatory adverse events occurred with lidocaine.
• Severity of hypoxia and need for interventions were lower with lidocaine (p=0.017 and p=0.028, respectively).

Clinical Implications

Consider IV lidocaine as an adjunct in propofol-based GI endoscopy sedation to decrease hypoxic events and movement, using the studied regimen; monitor for lidocaine-related adverse effects.

Limitations

• Single-center study; blinding not specified in abstract
• Concomitant midazolam and sufentanil may confound propofol and lidocaine effects

Future Directions

Multicenter, blinded RCTs to confirm generalizability; dose-response and safety profiling across procedural populations; explore mechanisms reducing hypoxia.