Background and aims
Some studies have shown that intravenous (IV) lidocaine reduces the dose requirement
of propofol in GI endoscopic procedures. We conducted this study to evaluate the efficacy
and safety of the combination of IV lidocaine and propofol compared with propofol
alone in GI endoscopic procedures.
Methods
We reviewed several databases from inception to October 13, 2020, to identify randomized
controlled trials (RCTs) that compared the role of IV propofol and lidocaine with
IV propofol plus placebo for sedation in endoscopic procedures. Our outcomes of interest
were the differences in total dose of propofol administered, procedure time, and intraoperative
adverse events. For categorical variables, we calculated pooled risk ratios with 95%
confidence intervals (CI); for continuous variables, we calculated standardized mean
difference (SMD) with 95% CI. Data were analyzed using a random effect model. We used
the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework
to ascertain the quality of evidence.
Results
We included 5 randomized controlled trials with 318 patients. We found that the total
dose of propofol administered was significantly lower in the lidocaine group than
the control group (SMD, −0.76; 95% CI, −1.09 to −0.42). We found no significant difference
in procedure time (SMD, 0.16; 95% CI, −0.26 to 0.57) or adverse events (risk ratio,
0.60; 95% CI, 0.35-1.03) between the groups. There was moderate to substantial heterogeneity
in the data. Quality of evidence based on the GRADE framework ranged from low to moderate.
Conclusions
Moderate quality of evidence suggests that IV lidocaine decreases the dose of propofol
administered for GI endoscopic procedures.
Abbreviations:
CI (confidence interval), GRADE (Grading of Recommendations Assessment, Development and Evaluation), IV (intravenous), PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis), RCT (randomized controlled trial), RR (risk ratio), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 20, 2021
Accepted:
January 11,
2021
Received:
October 29,
2020
Footnotes
If you would like to chat with an author of this article, you may contact Dr Kamal at [email protected]
DISCLOSURE: All authors disclosed no financial relationships.
Identification
Copyright
© 2021 by the American Society for Gastrointestinal Endoscopy
