A double‐blind randomized trial of low‐dose versus high‐dose topical anaesthesia in unsedated upper gastrointestinal endoscopy

Abstract

High-dose pharyngeal anaesthesia reduces patient discomfort during unsedated upper gastrointestinal endoscopy. However, patient tolerance is also influenced by clinical features, which might be useful in deciding which patients are suitable for this procedure.

Flavored anesthetic lozenge versus Xylocaine spray used as topical pharyngeal anesthesia for unsedated esophagogastroduodenoscopy: a randomized placebo-controlled trial

“…Jameson et al [9] found that lignocaine spray of 100 mg is superior to 50 mg with regard to reduction in patient discomfort and fewer gags in sedated EGD. Mulcahy et al [10] reached a similar conclusion when comparing 30-and 100-mg lidocaine spray in unsedated EGD. However, no direct comparison between 20-and 60-mg lignocaine as a topical anesthesia was performed in the past.…”

“…Mulcahy et al [10] found that more than onethird of patients request sedation after undergoing unsedated EGD. The use of midazolam as sedation in EGD is found to be beneficial and to improve patient tolerance [15,16].…”

New lidocaine lozenge as topical anesthesia compared to lidocaine viscous oral solution before upper gastrointestinal endoscopy

“…Both studies used drugs other than lidocaine, where oxybuprocaine is more potent and benzocaine is less potent than lidocaine 8. Furthermore, the patients in both studies also received sedation, which likely biases the assessment of the effects of topical anesthesia as sedation induces antegrade amnesia 9. A recent study by Canon et al5 compared the effectiveness of a lidocaine spray with a lozenge in a randomized placebo-controlled study in 191 unsedated consecutive patients 5.…”

Study of ideal topical pharyngeal anesthesia in upper gastrointestinal system endoscopy: A double-blind, randomized, controlled trial

“…In a study, high (100 mg) and low doses (30 mg) of the lidocaine spray were compared. A decrease was detected in the discomfort of patients who were administered high doses (22). In addition, we believe that the gel's lubricating effect is also important for this satisfaction.…”