Research Symposium Program - Individual Details

Lidocaine Dosage for EGD Sedation

Abstract

Propofol-based sedation for esophagogastroduodenoscopy (EGD) often requires careful anesthetic management to minimize adverse events. Lidocaine, an adjuvant to propofol, can reduce propofol requirements and improve patient outcomes. This study aimed to evaluate the impact of a weight-based lidocaine dosing regimen (1.5 mg/kg) on apneic events compared to a fixed low dose (50 mg) in adult patients undergoing EGD. A pre- and post-intervention survey design was employed to assess clinical practice changes among anesthesia providers within a U.S. hospital in the eastern region. Post-intervention, adherence to the recommended lidocaine dosing increased significantly, leading to a reduction in propofol requirements and fewer adverse events like apnea and hemodynamic instability. Adherence to the recommended dosage of 1.5 mg/kg of lidocaine 2% increased notably, with the number of practitioners adhering to this guideline doubling from 10 to 20 out of 25 respondents. Additionally, 18 practitioners reported notable improvements, including reduced propofol requirements and a lower incidence of adverse events such as apnea and hemodynamic instability. These findings highlight the importance of targeted education and evidence-based dosing practices in improving patient safety and optimizing anesthesia care for EGD procedures, illustrating how a well-structured educational initiative can bridge the gap between evidence-based recommendations and real-world clinical practice.

Keywords: Lidocaine, propofol, esophagogastroduodenoscopy, apneic events, sedation optimization