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

Çam, Hakan; Pehlıvan, Seda; Dağ, Muhammed Sait; Yılmaz, Nisbet; Demir, U; Gülşen, Murat Taner

doi:10.5152/tjg.2015.150322

Cited by 3 publications

(4 citation statements)

References 19 publications

(17 reference statements)

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“…We also observed that the topical pharyngeal anesthesia did not significantly reduce the discomfort score both immediately and one day after the endoscopic examinations [7.2 (5–9) vs. 7.5 (6–9), P = 0.210; 2.3 (0–3) vs. 2.6 (0–4), P = 0.095, respectively], making our results consistent with a previous study 19 . However, it was reported that lidocaine is the ideal pharyngeal anesthetic to ensure the adaptation of the patient to the procedure and to decrease anxiety and discomfort during the procedure 7 . A lack of standardized outcome measurements and standardized sedation strategies may be the reason for the heterogeneity of the conclusions among different studies 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Propofol sedation has been widely introduced in sedated endoscopic examinations, which has the advantages of less adverse events, high satisfaction, less discomfort and simple administration 3 – 5 . For those sedated patients, whether lidocaine topical pharyngeal anesthesia should be administered is still in doubt 6 , although lidocaine topical pharyngeal anesthesia as a routine pretreatment for esophagogastroduodenoscopy may facilitate the intubation of the endoscopy and reduce the injury of the pharyngeal mucosa 7 . The European Society of Gastrointestinal Endoscopy, the European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anesthesiology Guidelines for the non-anesthesiologist administration of propofol for gastrointestinal endoscopy have not made any specific recommendations on this topic 8 , 9 , mainly because the role of pharyngeal anesthesia during propofol sedation for upper digestive endoscopy has not been completely clarified 10 , 11 .…”

Section: Introductionmentioning

confidence: 99%

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Topical pharyngeal anesthesia provides no additional benefit to propofol sedation for esophagogastroduodenoscopy: a randomized controlled double-blinded clinical trial

Sun

Zhang

et al. 2018

Sci Rep

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Propofol sedation has been applied during esophagogastroduodenoscopy procedures, but whether topical pharyngeal anesthesia should be administered at the same time has rarely been reported. Our study examined the role of topical pharyngeal anesthesia in sedated endoscopies in a randomized controlled double-blinded clinical trial. A total of 626 patients who underwent sedated esophagogastroduodenoscopy were randomized into the experimental group (n = 313) or the control group (n = 313). The discomfort score, immediately and one day after the procedure, was not statistically significant [7.2 (5–9) vs. 7.5 (6–9), P = 0.210; 2.3 (0–3) vs. 2.6 (0–4), P = 0.095, respectively]. Two patients in the experimental group and three patients in the control group needed oral medication for pharyngeal discomfort (P = 0.354). The satisfaction score was 9.2 (8–10) in the experimental group and 8.9 (7–10) in the control group (P = 0.778). Lidocaine topical pharyngeal anesthesia in propofol-sedated esophagogastroduodenoscopy did not further reduce the pharyngeal discomfort or improve the satisfaction. This clinical trial was registered at ClinicalTrials.gov (ClinicalTrials.gov ID: NCT03070379).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Topical pharyngeal anesthesia provides no additional benefit to propofol sedation for esophagogastroduodenoscopy: a randomized controlled double-blinded clinical trial

Sun

Zhang

et al. 2018

Sci Rep

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“…In non-sedated adult patients undergoing EGD, the use of TPA is a common practice. While its efficacy was questioned by Davis et al more than 20 years ago, several studies have since demonstrated that TPA improves patient tolerance of the procedure, improves patient satisfaction, and facilitates the esophageal intubation (13,14,(31)(32)(33). Results of studies looking at the addition of topical anesthesia for adult patients receiving procedural sedation for EGD were less straightforward (17,34).…”

Section: Discussionmentioning

confidence: 99%

“…Topical pharyngeal anesthetics (TPAs) can blunt the cough and gag reflexes and decrease the incidence of laryngospasm (12). While a number of studies have reported the use of a TPA in adults undergoing non-sedated EGD (2,(13)(14)(15)(16)(17), only 2 small pediatric studies have reported its use in ketamine-based sedated EGDs (11,18). None reported its use in children undergoing propofolbased sedated EGD.…”

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confidence: 99%

Topical Pharyngeal Anesthesia in Sedated Pediatric Patients Undergoing Esophagogastroduodenoscopy

Aljabari

Ohler

Waheed

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Pediatric patients undergoing esophagogastroduodenoscopy (EGD) commonly receive procedural sedation for comfort and to facilitate the procedure. EGD with procedural sedation carries the risk of several airway incidents and/or adverse events (AIAE). Topical pharyngeal anesthetics (TPAs) can blunt the airway reflexes and decrease the incidence of laryngospasm but has not been well studied with EGD under procedural sedation. We aimed to study the effect of adding a TPA to propofol-based sedation on the rate of AIAE. Methods: This is a single-center, retrospective, observational cohort study. We compare AIAE rates (coughing, gagging, apnea, airway obstruction, and laryngospasm) in children who received TPA as part of their propofol-based procedural sedation for EGD with those who did not receive TPA. Results: In 2021, 73 patients received TPA as part of the procedural sedation for EGD and 123 did not. The overall rate of AIAE was high with 75 (38%) patients experiencing 1 or more AIAE. Patients who received benzocaine spray experienced more AIAE than the control group [adjusted odds ratio (aOR) = 1.16; 95% confidence interval (CI): 1.01-1.34; P = 0.037]. Coughing, gagging, apnea with desaturation rates, and laryngospasm were similar in both groups (coughing aOR = 1.

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Application of topical pharyngeal anesthesia to reduce adverse reactions during painless gastroscopy: A prospective randomized study

Lin¹,

Sun²,

Lin³

et al. 2023

THC

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BACKGROUND: Studies have reported that certain adverse reactions can occur during painless gastroscopy examination. Knowing how to decrease the risks and incidence of adverse reactions is of great importance. OBJECTIVE: To investigate whether topical pharyngeal anesthesia combined with intravenous anesthesia is superior to intravenous anesthesia alone in patients undergoing painless gastroscopy and to determine whether this combined approach had any additional benefits. METHODS: Three hundred patients undergoing painless gastroscopy were randomly assigned to either the control group or the experimental group. In the control group, patients were anesthetized with propofol, while patients in the experimental group received propofol combined with 2% lidocaine spray for topical pharyngeal anesthesia. Hemodynamic parameters before and after the procedure, including the heart rate (HR), mean arterial pressure (MAP), and pulse oxygen saturation (SPO2) were recorded. Any adverse reactions experienced by the patient, including choking and respiratory depression, and the total dosage of propofol required during each procedure were also documented. RESULTS: Compared with pre-anesthetic data, the HR, MAP, and SPO2 were reduced after the completion of the painless gastroscopy procedure in both groups. However, the HR, MAP, and SPO2 measurements taken after the gastroscopy were significantly lower in the control group than those of the experimental group (P< 0.05); thus, the hemodynamic parameters of the experimental group were more stable. Compared with the control group, there was significant reduction in the total amount of propofol administered in the experimental group (P< 0.05). The incidence of adverse reactions, including choking and respiratory depression, was significantly lower in the experimental group (P< 0.05). CONCLUSION: The results demonstrated that the application of topical pharyngeal anesthesia in painless gastroscopy can significantly reduce the incidence of adverse reactions. Thus, the combination of topical pharyngeal and intravenous anesthesia is worthy of clinical application and promotion.

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

Cited by 3 publications

References 19 publications

Topical pharyngeal anesthesia provides no additional benefit to propofol sedation for esophagogastroduodenoscopy: a randomized controlled double-blinded clinical trial

Topical pharyngeal anesthesia provides no additional benefit to propofol sedation for esophagogastroduodenoscopy: a randomized controlled double-blinded clinical trial

Topical Pharyngeal Anesthesia in Sedated Pediatric Patients Undergoing Esophagogastroduodenoscopy

Application of topical pharyngeal anesthesia to reduce adverse reactions during painless gastroscopy: A prospective randomized study

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