Efficacy of IV Lidocaine in Reducing Propofol-Related Adverse Events During GI Endoscopy: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis evaluated the efficacy of IV lidocaine as an adjunct to propofol sedation in reducing propofol-related adverse events during GI endoscopy. Randomized controlled trials (RCTs) comparing IV lidocaine plus propofol vs. propofol alone in adults undergoing GI endoscopy were systematically identified through PubMed, Web of Science, EMBASE, and the Cochrane Library up to December 2025. The primary outcome was the incidence of propofol-related adverse events. Data were pooled using a fixed-effect model, and risk of bias was assessed with the Cochrane Risk of Bias 2 tool. Three RCTs involving 530 patients were included. Meta-analysis revealed that lidocaine significantly reduced the risk of propofol-related adverse events (risk ratio = 0.523, 95% CI: 0.361-0.76) with low heterogeneity (I² = 0%). Sensitivity analysis confirmed the robustness of the findings, although funnel plot asymmetry suggested potential publication bias. In conclusion, IV lidocaine may reduce propofol-related adverse events during GI endoscopy; however, further high-quality studies are needed to confirm these results.