Effects of intravenous lidocaine or topical lidocaine applied before upper gastrointestinal endoscopy on hemodynamics and throat pain

Abstract

Aim: Upper gastrointestinal endoscopy is commonly performed as an outpatient procedure, which may lead to overlooking potential arrhythmias. In this study, we aimed to investigate the effects of intravenous or topical lidocaine on hemodynamics, QT interval and throat pain in patients scheduled for upper gastrointestinal endoscopy. Material and Methods: The patients were randomly divided into three groups: Group I received 1 mg/kg IV(intravenous) propofol induction, Group II received 1 mg/kg IV propofol induction and topical lidocaine (9 sprays, 3 sprays at 10-second intervals, totaling 90 mg), and Group III received 1 mg/kg IV propofol induction and 1.5 mg/kg IV lidocaine induction. ECGs(Electrocardiogram) were obtained before and after the procedure, and hemodynamic data were recorded. Throat pain in patients was assessed after the procedure. Results: There was a statistically significant difference in systolic blood pressure (SBP) values at the 3rd minute among the three groups (p=0.021). The SBP values at the 3rd and 5th minutes in Group I were significantly lower compared to Groups II and III (p=0.021, p=0.012 retrospectively). There was a statistically significant difference in diastolic blood pressure (DBP) values among the three measurements in Group I (p=0.0001). The DBP values at 1 minute in Group I were significantly higher compared to the values at the 3rd and 5th minutes. Additionally, there was a statistically significant difference in postoperative QTc values among the groups (p=0.001). Discussion: We concluded that 1.5 mg/kg IV lidocaine effectively suppressed the hemodynamic response secondary to adrenergic activation during upper gastrointestinal endoscopy and also suppressed the increase in QT and QTc values.