The application of lidocaine to alleviate the discomfort of nasogastric tube insertion

Lor, You-Chen; Shih, Pei-Ching; Chen, Hsin-Hao; Liu, Shu-Jung; Chao, Hsingchu-Chu; Hwang, Lee-Ching; Hsu, Y W; Yeh, Tzu-Lin

doi:10.1097/md.0000000000009746

Cited by 17 publications

(10 citation statements)

References 17 publications

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“…A number of studies have shown an effect of lidocaine on the relief of pain related to nasogastric catheterization (Cullen et al, ; Kuo et al, ; Lor et al, ; Pongprasobchai et al, ; Uri et al, ; Wolfe, Fosnocht, & Linscott, ); however, to our knowledge, no study has tested its efficacy in NEC. To the best of our knowledge, our study is the first randomized, placebo‐controlled, triple‐blind clinical trial to compare the efficacy of 10% lidocaine spray and 2% lidocaine gel in pain relief during NEC.…”

Section: Discussionmentioning

confidence: 99%

“…Lidocaine has proven to be an effective analgesic for pain relief during gastrointestinal intubation, regardless of its delivery method. A recent systematic review analysed different doses and delivery methods of lidocaine and showed the benefit of lidocaine in relieving procedural pain associated with NGT insertion, especially in the adult population, with a mean difference of −26.05 [95% CI: −28.21 to −23.89] (Lor et al, ). Another systematic review and meta‐analysis that included 5 randomized clinical trials (RCTs) with 212 subjects investigated only the analgesic effect of nebulized lidocaine.…”

Section: Discussionmentioning

confidence: 99%

“…There are few reports of institutions that have adopted guidelines for procedural pain management, and few trials evaluating pain management during gastrointestinal intubation have been reported in scientific journals (Kuo, Yen, Fetzer, & Lee, ; Lor et al, ). Unlike endoscopic procedures in which patients undergo sedation and analgesia, NEC is routinely performed in clinical practice using only 2% lidocaine gel at the distal tip of the catheter.…”

Section: Introductionmentioning

confidence: 99%

“…Unlike endoscopic procedures in which patients undergo sedation and analgesia, NEC is routinely performed in clinical practice using only 2% lidocaine gel at the distal tip of the catheter. Although the lidocaine gel acts as a local anaesthetic, its gel presentation has the additional effect of facilitating sliding of the catheter during insertion (Lor et al, ; Uri, Yosefov, Haim, Behrbalk, & Halpern, ).…”

Section: Introductionmentioning

confidence: 99%

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Analgesic efficacy of 10% lidocaine spray during nasoenteral catheterization: Randomized triple‐blind trial

Oliveira

Ribeiro

Oliveira

et al. 2019

European Journal of Pain

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Background Pain is a common experience during nasoenteral catheterization. Although the procedure causes discomfort and distress to patients, procedural pain remains neglected and undertreated. Objective To evaluate the analgesic efficacy of the use of 10% lidocaine spray during nasoenteral catheterization. Method A randomized, triple‐blind trial of 50 patients was performed. The patients were randomly assigned to two groups: an intervention group (IG), in which 10% lidocaine spray combined with 2% lidocaine gel was used, and a control group (CG), in which a saline solution spray combined with 2% lidocaine gel was used. Pain and discomfort were assessed during and after nasoenteral catheterization using numerical rating scale (NRS) and the visual analogue scale (VAS), respectively. Results Intervention group participants reported lower pain scores during (0.20 ± 0.71 vs. 5.00 ± 2.84, p < .001; |d| = −0.677) and after (0.00 ± 0.00 vs. 2.80 ± 2.83, p < .001; |d| = −0.718) nasoenteral catheterization compared to the CG. Conclusion Spraying 10% lidocaine spray before nasoenteral catheterization was most effective for relieving discomfort and pain, with lower pain and discomfort recorded in NRS and VAS. Topical administration of 10% lidocaine spray is therefore a suggested measure for procedural pain relief related to nasoenteral catheterization. Significance The use of 10% lidocaine spray was more effective in relieving procedural pain and discomfort during nasoenteral catheterization. Patients who received 10% lidocaine spray registered lower discomfort and pain scores than those from 2% lidocaine gel group; there were less complications among patients in the IG.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Analgesic efficacy of 10% lidocaine spray during nasoenteral catheterization: Randomized triple‐blind trial

Oliveira

Ribeiro

Oliveira

et al. 2019

European Journal of Pain

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show abstract

“…Lignocaine jelly is commonly used prior to urinary catheterization, urological procedures, and nasogastric tube insertion, etc., for smooth passage of the tubes and also to provide topical anesthesia. [ 1 2 3 ] Often, it has been observed that awake patients complain of burning sensation, and tachycardia and hypertension are observed in anesthetized patients following nasal application of lignocaine jelly.…”

Section: Introductionmentioning

confidence: 99%

Comparison of hemodynamic changes to nasal application of lignocaine jelly versus lubricant gel and responses to Ryle's tube insertion following their use in patients under general anesthesia

et al. 2020

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Background: Awake patients complain of burning sensation following nasal application of lignocaine jelly. Aim of the Study: The aim of the study was to assess hemodynamic changes, ease of insertion, number of attempts taken, and time required for insertion of Ryle's tube following nasal application of 2% lignocaine jelly versus lubricant gel in patients undergoing surgeries under general anesthesia. Settings and Design: This was a prospective, randomized, open-label study conducted in a tertiary care institute. Subjects and Methods: Eighty patients undergoing surgeries under general anesthesia who required insertion of a Ryle's tube were included. In Group A, 2% lignocaine jelly was used, whereas in Group B, lubricant gel was used prior to Ryle's tube insertion, after induction of anesthesia. Hypertension and/or tachycardia were managed by increasing sevoflurane by 0.5%–1%, followed by propofol bolus of 0.5 mg.kg −1 . Statistical Tests Used: Chi-square test and Independent samples t test. Results: Both heart rate and mean arterial pressure were significantly higher at 1 min after nasal application of lignocaine jelly and 1 and 5 min after Ryle's tube insertion in Group A compared to Group B. Ease of insertion of Ryle's tube, number of attempts, and time taken for insertion were comparable in both groups. Significantly higher number of patients in Group A required sevoflurane to be increased and needed propofol boluses. Conclusion: Use of lubricant gel for aiding insertion of Ryle's tube in patients under general anesthesia was associated with attenuated heart rate and blood pressure responses without affecting the ease, number of attempts, or time taken for successful insertion of the Ryle's tube.

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Effectiveness of Lidocaine nasal drops versus placebo drops for reducing the discomfort of nasogastric tube insertion: a randomized controlled trial study

Tongyoo,

Thangthong,

Liwattanakun

et al. 2023

Surg Today

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The application of lidocaine to alleviate the discomfort of nasogastric tube insertion

Abstract: Supplemental Digital Content is available in the text

Cited by 17 publications

References 17 publications

Analgesic efficacy of 10% lidocaine spray during nasoenteral catheterization: Randomized triple‐blind trial

Analgesic efficacy of 10% lidocaine spray during nasoenteral catheterization: Randomized triple‐blind trial

Comparison of hemodynamic changes to nasal application of lignocaine jelly versus lubricant gel and responses to Ryle's tube insertion following their use in patients under general anesthesia

Effectiveness of Lidocaine nasal drops versus placebo drops for reducing the discomfort of nasogastric tube insertion: a randomized controlled trial study

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