Fujian University of Traditional Chinese Medicine

education 📍 Fuzhou, China
2
Lidocaine Infusion Publications
4
Lidocaine Infusion Researchers

Associated Institutions

Fujian Provincial People's Hospital
related

Publications

Intravenous Lidocaine and Cognitive Recovery After Endoscopic Submucosal Dissection: A Randomized Controlled Trial.

Liang Y, Qian B, Zhuo Y, Zhang J, Gao W , et al.
Drug design, development and therapy •

While intravenous lidocaine reduces propofol requirements during procedures, its effects on postoperative cognitive function remain uncertain. This study evaluated whether lidocaine enhances cognitive recovery in patients undergoing endoscopic submucosal dissection (ESD) with propofol sedation. In this randomized, double-blind, placebo-controlled trial, 234 patients undergoing colorectal ESD received either intravenous lidocaine (1.5 mg/kg bolus followed by 2 mg/kg/h infusion) or a saline placebo. The standard sedation protocol included sufentanil 0.1 Οg/kg and propofol for induction, with additional propofol as needed to maintain adequate sedation depth. The primary outcome was cognitive recovery on postoperative day 3 assessed by the PostopQRS cognitive domain. Secondary outcomes included recovery patterns at four timepoints (30 minutes, 1, 3, and 7 days), propofol consumption, injection pain, satisfaction scores, and adverse events. The lidocaine group demonstrated significantly better cognitive recovery than the placebo group [relative risk 1.15, 95% confidence interval (CI) 1.04-1.28, p=0.008], with benefits lasting through day 7 (p=0.035). Lidocaine administration resulted in a 25% reduction in propofol consumption [230 (208-258) mg compared to 305 (261-354) mg, with a median difference of -71 mg, 95% CI -85 to -57, p<0.001]. Additionally, injection pain scores were significantly lower in the lidocaine group [median score of 0 (0-1) versus 1 (0-3), p<0.001]. The incidence of hypotensive episodes was also reduced with lidocaine administration (12.8% compared to 24.8%, p=0.019). Importantly, no lidocaine toxicity was observed. Intravenous lidocaine was associated with enhanced cognitive recovery on postoperative day 3, as well as decreased propofol requirements, injection pain, and hypotensive episodes during ESD. These results indicate that lidocaine may serve as an effective adjuvant in endoscopic sedation protocols. ClinicalTrials.gov, NCT05750056.

Systemic lidocaine versus erector spinae plane block for improving quality of recovery after laparoscopic cholecystectomy: A randomized controlled trial.

Lin Z, Chen C, Xie S, Chen L, Yao Y , et al.
Journal of clinical anesthesia •

To compare intravenous lidocaine, ultrasound-guided erector spinae plane block (ESPB), and placebo on the quality of recovery and analgesia after laparoscopic cholecystectomy. A prospective, triple-arm, double-blind, randomized, placebo-controlled non-inferiority trial. A single tertiary academic medical center. 126 adults aged 18-65 years undergoing elective laparoscopic cholecystectomy. Patients were randomly allocated to one of three groups: intravenous lidocaine infusion (1.5 mg/kg bolus followed by 2 mg/kg/h) plus bilateral ESPB with saline (25 mL per side); bilateral ESPB with 0.25% ropivacaine (25 ml per side) plus placebo infusion; or bilateral ESPB with saline (25 ml per side) plus placebo infusion. The primary outcome was the 24-h postoperative Quality of Recovery-15 (QoR-15) score. The non-inferiority of lidocaine versus ESPB was assessed with a margin of -6 points and 97.5% confidence interval (CI). Secondary outcomes included 24-h area under the curve (AUC) for pain scores, morphine consumption, and adverse events. 124 patients completed the study. Median (IQR) 24-h QoR-15 scores were 123 (117-127) for lidocaine, 124 (119-126) for ESPB, and 112 (108-117) for placebo. Lidocaine was non-inferior to ESPB (median difference  -1, 97.5% CI: -4 to ∞). Both lidocaine (median difference 9, 95% CI: 6-12, P < 0.001) and ESPB (median difference 10, 95% CI: 7-13, P < 0.001) were superior to placebo. AUC for pain scores and morphine use were lower with lidocaine and ESPB versus placebo (P < 0.001 for all), with no significant differences between lidocaine and ESPB. One ESPB patient reported a transient metallic taste; no other block-related complications occurred. For patients undergoing laparoscopic cholecystectomy, intravenous lidocaine provides a non-inferior quality of recovery compared to ESPB without requiring specialized regional anesthesia procedures. Lidocaine may offer a practical and accessible alternative within multimodal analgesia pathways.