Comparison of Lidocaine Spray and Lidocaine Ice Popsicle in Patients Undergoing Unsedated Esophagogastroduodenoscopy: A Single Center Prospective Randomized Controlled Trial

Abstract

Purpose: Esophagogastroduodenoscopy (EGD) under topical pharyngeal anesthesia has the advantage of avoiding the unwanted cardiopulmonary adverse events experienced following intravenous sedation. Lidocaine spray is a common anesthetic option and is safe for unsedated EGD. Although several studies have compared different topical anesthetic agents, their formulations, and delivery techniques, questions still remain concerning the optimal mode of administration. We have designed a lidocaine formulation in the form of an ice popsicle and compared its effectiveness and tolerability with lidocaine spray in patients undergoing unsedated EGD. Methods: This was a single-center prospective randomized controlled trial. Unsedated EGD patients were randomly allocated the lidocaine spray [Group (Gp) A] or lidocaine ice popsicle (Gp B) formulation. Results: In total, 204 unsedated EGD patients were evaluated. Compared to the spray, the lidocaine ice popsicle group showed better scores for effects in terms of endoscopist satisfaction (Gp A, 7.28±1.

Reply to “Evaluation of pharyngeal lidocaine anesthesia for esophagogastroduodenoscopy: Double‐blind randomized control trial” by Martín‐Marcos et al.

“…Due to the blocking of upper airway sensory receptors, topical lidocaine may often result in postoperative pharyngeal discomfort, including dryness and dysphagia, especially after a short procedure 3 . We believe that this study would have provided more useful data about the effectiveness of pharyngeal lidocaine anesthesia for esophagogastroduodenoscopy if the design had included a postoperative assessment of patients’ satisfaction, as performed in previous studies 4,5 …”

“…3 We believe that this study would have provided more useful data about the effectiveness of pharyngeal lidocaine anesthesia for esophagogastroduodenoscopy if the design had included a postoperative assessment of patients' satisfaction, as performed in previous studies. 4,5…”