Efficacy and safety of supplemental intravenous lidocaine for sedation in gastrointestinal endoscopic procedures: systematic review and meta-analysis of randomized controlled trials
| Autor: | Eric Qualkenbush, Zaid Imam, Collin Henry, Sachit Sharma, Wade Lee-Smith, Muhammad Ali Khan, Jay Patel, Colin W. Howden, Zubair Khan, Faisal Kamal, Ellen Petryna, Dawit Jowhar |
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| Rok vydání: | 2020 |
| Předmět: |
Lidocaine
Sedation Placebo Endoscopy Gastrointestinal law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Radiology Nuclear Medicine and imaging Anesthesia Adverse effect Propofol Randomized Controlled Trials as Topic business.industry Gastroenterology Strictly standardized mean difference 030220 oncology & carcinogenesis Relative risk 030211 gastroenterology & hepatology medicine.symptom business medicine.drug |
| Zdroj: | Gastrointestinal endoscopy. 93(6) |
| ISSN: | 1097-6779 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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