Intravenous lidocaine reduces propofol requirements during endoscopic ultrasound: a randomized, double-blinded,...

Propofol as a sole sedative agent for endoscopic ultrasound (EUS) often causes respiratory and circulatory depression. This study aimed to evaluate the impact of intravenous lidocaine on propofol dose, propofol-related complications, patient safety and comfort during EUS.

Eighty patients scheduled for EUS were randomly allocated to two groups. Lidocaine group (Group L, n = 40) received a 1.5 mg/kg lidocaine bolus followed by a 2 mg/kg/h infusion, while the control group (Group C, n = 40) received an equal volume of saline. Sedation was induced with 2 mg/kg propofol in both groups, followed by a continuous intravenous infusion of propofol at 4 mg/kg/h. 50 mg propofol was administered as needed, and the propofol infusion rate was also increased by 0.5 mg/kg/h. The primary outcome was total propofol dose.

Group L showed less total propofol dose (p = 0.007). In addition, maintenance (p = 0.018) and supplemental propofol doses (p = 0.016) were also reduced in Group L. Group L showed less incidence of intraoperative hypoxia, more stable hemodynamic profile, shorter induction and recovery times, reduced postoperative pain, higher patient and endoscopist satisfaction scores compared to Group C.

Intravenous lidocaine reduced total propofol dose during EUS. It also improved safety and procedural efficiency, although these findings should be interpreted with caution and require confirmation in larger studies.

The study was registered with the Chinese Clinical Trials Registry (ChiCTR2400086658) on 07/08/2024.