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已发表论文
静脉注射利多卡因与内镜黏膜下剥离术后认知功能恢复：一项随机对照试验
Authors Liang Y, Qian B , Zhuo Y, Zhang J , Gao W , Li H, Zhang X, Lin W
Received 4 August 2025
Accepted for publication 13 November 2025
Published 22 November 2025 Volume 2025:19 Pages 10343—10355
DOI https://doi.org/10.2147/DDDT.S557688
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Tin Wui Wong
Yagui Liang,1,* Bin Qian,2,* Yifen Zhuo,3,* Jingxuan Zhang,4 Weitao Gao,4 Hao Li,4 Xiaohong Zhang,4 Wenjun Lin4
1Department of Anesthesiology, Mindong Hospital Affiliated to Fujian Medical University, Fuan, Fujian, People’s Republic of China; 2Department of Anesthesiology, People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, People’s Republic of China; 3Department of Anesthesiology, Xiamen Haicang Hospital, Xiamen, Fujian, People’s Republic of China; 4Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, Fujian, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaohong Zhang, Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No. 134, Dongjie Street, Fuzhou, Fujian, 350001, People’s Republic of China, Email zhxh@fjmu.edu.cn Wenjun Lin, Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No. 134, Dongjie Street, Fuzhou, Fujian, 350001, People’s Republic of China, Email 1231120224@fjmu.edu.cn
Background and Purpose: 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.
Patients and Methods: 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 μg/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.
Results: 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.
Conclusion: 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.
Registration: ClinicalTrials.gov, NCT05750056.
Keywords: lidocaine, postoperative cognitive dysfunction, endoscopic submucosal dissection, propofol, sedation, cognitive recovery
1Department of Anesthesiology, Mindong Hospital Affiliated to Fujian Medical University, Fuan, Fujian, People’s Republic of China; 2Department of Anesthesiology, People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, People’s Republic of China; 3Department of Anesthesiology, Xiamen Haicang Hospital, Xiamen, Fujian, People’s Republic of China; 4Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, Fujian, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaohong Zhang, Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No. 134, Dongjie Street, Fuzhou, Fujian, 350001, People’s Republic of China, Email zhxh@fjmu.edu.cn Wenjun Lin, Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No. 134, Dongjie Street, Fuzhou, Fujian, 350001, People’s Republic of China, Email 1231120224@fjmu.edu.cn
Background and Purpose: 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.
Patients and Methods: 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 μg/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.
Results: 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.
Conclusion: 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.
Registration: ClinicalTrials.gov, NCT05750056.
Keywords: lidocaine, postoperative cognitive dysfunction, endoscopic submucosal dissection, propofol, sedation, cognitive recovery