Is oropharyngeal anaesthesia with topical lignocaine useful in upper gastrointestinal endoscopy?

Abstract

The aim of this study was to determine n..etller patients' toldrance of upper gastrointestinal endoscopy is related to the dose of lignocaine spray used for oropharyngeal anaesthesia and to measure plasma concentrations at these doses. Sixty consecutive patients undergoing routine upper gastrointestinal endoscopy with sedation were randomized to receive lignocaine spray 50 mg (Group A), 100 mg (Group B) or 200 mg (Group C). Patient, endoscopist and endoscopy nurse were unaware of the variation in dose used. Each patient's tolerance of the intubation and of the remainder of the gastroscopy was assessed independently by the patient, endoscopy nurse, and endoscopist using a visual analogue scale. Plasma lignocaine concentration was measured at 20, 40, 60 and 80 min after administration of the spray. Fifty (83 %) patients were unable to recaIl either the intubation, or the procedure. On the endoscopy nurse's assessment, the patients in Group B tolerated the intubation better than those in Group A, and Groups B and C tolerated

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

“…The effectiveness of topical anesthesia is presumably related to the dosage of lignocaine. 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.…”

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

“…The effectiveness of topical anesthesia is probably related to the lidocaine dosage. Other studies showed that 100 mg of lidocaine is an effective dose administered before an UGE 9,12…”

Sedation in digestive endoscopy: the Athens international position statements

“…Studies have shown that topical anaesthesia of the oropharynx is beneficial in unsedated patients undergoing OGD. [1][2][3] Its value in sedated patients has been more difficult to demonstrate, however. A recent meta-analysis indicated that it does improve patient tolerance, as assessed by both patient and examiner, during OGD in sedated patients.…”