Efficacy and safety of supplemental intravenous lidocaine for sedation in gastrointestinal endoscopic procedures: systematic review and meta-analysis of randomized controlled trials.

Anesthesia Endoscopy, Gastrointestinal Humans Lidocaine Propofol Randomized Controlled Trials as Topic

Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
06 2021
Historique:
received: 29 10 2020
accepted: 11 01 2021
pubmed: 25 1 2021
medline: 3 6 2021
entrez: 24 1 2021
Statut: ppublish

Résumé

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. 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. 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. Moderate quality of evidence suggests that IV lidocaine decreases the dose of propofol administered for GI endoscopic procedures.

Sections du résumé

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.

Identifiants

DOI: 10.1016/j.gie.2021.01.008 PMID: 33485876
pubmed: 33485876
pii: S0016-5107(21)00035-3
doi: 10.1016/j.gie.2021.01.008
pii:
doi:

Substances chimiques

Lidocaine 98PI200987
Propofol YI7VU623SF

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1241-1249.e6

Informations de copyright

Copyright © 2021 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Auteurs

Faisal Kamal (F)

Division of Gastroenterology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Muhammad Ali Khan (MA)

Division of Gastroenterology, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Wade Lee-Smith (W)

Mulford Health Sciences Library, University of Toledo, Toledo, Ohio, USA.

Sachit Sharma (S)

Department of Medicine, University of Toledo, Toledo, Ohio, USA.

Zaid Imam (Z)

Division of Gastroenterology, William Beaumont Hospital, Royal Oak, Michigan, USA.

Dawit Jowhar (D)

Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Collin Henry (C)

Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Zubair Khan (Z)

Division of Gastroenterology, University of Texas at Houston, Houston, Texas, USA.

Ellen Petryna (E)

Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Jay R Patel (JR)

Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Eric A V Qualkenbush (EAV)

Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Colin W Howden (CW)

Division of Gastroenterology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Anesthésie et analgésie › Anesthésie › Efficacy and safety of supplemental...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Endoscopie › Endoscopie digestive › Endoscopie gastrointestinale › Efficacy and safety of supplemental...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Efficacy and safety of supplemental...
questionsmedicales.fr › Composés chimiques organiques › Amines › Dérivés de l'aniline › Anilides › Acétanilides › Lidocaïne › Efficacy and safety of supplemental...
questionsmedicales.fr › Composés chimiques organiques › Hydrocarbures › Hydrocarbures cycliques › Hydrocarbures aromatiques › Dérivés du benzène › Phénols › Propofol › Efficacy and safety of supplemental...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › Efficacy and safety of supplemental...