Comparison of Propofol-Lidocaine and Propofol-Fentanyl for Total Intravenous Anesthesia during Day-Case Colonoscopy: A Randomized Controlled Trial
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Abstract
BACKGROUND: Colonoscopy is generally considered an uncomfortable procedure.
OBJECTIVES: To compare recovery time, intraoperative adverse events, and total propofol consumption between propofol-lidocaine and propofol-fentanyl regimens for day-case colonoscopy.
METHODS: This randomized, double-blind, controlled study was conducted in 60 patients with American Society of Anesthesiologists (ASA) physical status I–II, aged 18–64 years and of either sex. Thirty patients were randomly assigned to each group. The propofol-fentanyl (PF) group received fentanyl 1 µg/kg, whereas the propofol-lidocaine (PL) group received lidocaine 1.5 mg/kg intravenously, followed by induction with propofol 1 mg/kg. Hemodynamic parameters, intraoperative adverse events, total propofol consumption, and recovery time were assessed.
RESULTS: The PL group had a longer recovery time (4.2 (2.5–7.5) vs. 2.4 (2.1–4.4) min; p=0.027), greater total propofol consumption (170 (130–200) vs. (130 (90–180) mg; p=0.005), and longer induction time (67 (54–94) sec vs. 47 (37-66) sec; p=0.002) than the PF group. Adverse events were comparable. The reduction in mean arterial pressure from baseline during the first 7.5 min after induction was significantly less pronounced in the PL group.
CONCLUSIONS: Propofol-lidocaine TIVA was associated with longer induction and recovery times and greater total propofol consumption than propofol-fentanyl, while intraoperative adverse events were comparable between groups. Lidocaine attenuated the severity of hypotension during early induction
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