Optimal Lidocaine Dosing for Hemodynamic Stability in Elderly Patients

August 14, 2025
Optimal Lidocaine Dosing for Hemodynamic Stability in Elderly Patients

In a prospective randomized study conducted by researchers at Jiaxing University Affiliated Women and Children’s Hospital, the optimal dose of lidocaine as an adjunct to propofol-remifentanil for endotracheal intubation in elderly female patients was investigated. The study, which included 240 eligible participants, aimed to determine how different doses of lidocaine influenced hemodynamic stability and the incidence of post-induction hypotension during surgery.

Lidocaine is a local anesthetic known for its efficacy in stabilizing hemodynamic status, particularly in elderly patients who are at higher risk for perioperative complications. The participants were divided into three groups receiving lidocaine doses of 0.5 mg/kg, 1.0 mg/kg, and 1.5 mg/kg, respectively. Continuous monitoring of hemodynamic parameters was conducted 10 minutes post-anesthesia induction. The results indicated a significantly lower incidence of hypotension in the groups receiving higher doses of lidocaine, with hypotension occurring in 51.4% of the 0.5 mg/kg group, compared to only 13.0% in the 1.0 mg/kg group and 13.8% in the 1.5 mg/kg group.

According to Dr. Fei Xiao, the lead investigator and anesthesiologist at the hospital, “The findings suggest that a 1.0 mg/kg dose of lidocaine is optimal in reducing the requirement for norepinephrine to manage hypotension, thereby enhancing the safety of anesthesia for elderly patients.” The study also highlighted that while both 1.0 mg/kg and 1.5 mg/kg dosages effectively mitigated the risk of hypotension, there was no significant difference in outcomes between these two doses.

The clinical trial, registered under the Chinese Clinical Trial Registry (ChiCTR2400092990), adhered to ethical standards and included participants aged over 60 who were undergoing laparoscopic gynecologic surgery. Exclusion criteria ensured that participants with significant cardiovascular conditions or uncontrolled hypertension were not included, thereby focusing on a specific patient demographic that represents a growing segment of surgical patients.

The implications of this research are significant given the increasing elderly population undergoing surgical procedures, which necessitates careful management of anesthesia to reduce complications. As noted by Dr. Yan Zhu, a professor of anesthesiology at the institution, “This study provides crucial insights into anesthetic dosing that may help improve surgical outcomes for vulnerable populations.”

Future studies may expand on these findings by exploring the effects of lidocaine dosages across different surgical procedures and patient demographics. The researchers emphasize the need for additional research to validate these results and explore the potential benefits of lidocaine in other contexts of anesthesia. Such studies could pave the way for standardized protocols that enhance patient safety and surgical efficacy in elderly populations.

In conclusion, the evidence supports using 1.0 mg/kg of lidocaine as an effective adjunct for propofol-remifentanil during endotracheal intubation in elderly female patients, potentially setting a new standard in anesthetic practice for this demographic. Further investigations are warranted to explore the broader applicability of these findings across various surgical contexts.

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lidocainehemodynamic stabilityelderly patientspropofolremifentanilanesthesiaintubationhypotensionnorepinephrineJiaxing UniversityClinical Trialsurgical complicationsanesthesiologyelderly surgerygynecologic surgerypropofol dosinganesthesia managementpostoperative outcomescardiovascular safetylocal anestheticsrandomized studyanesthesia protocolsmedical researchpatient demographicssurgical anesthesiamedical ethicsdosage optimizationclinical guidelinesanesthetic agentselderly health care

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