Viscous lidocaine solution versus lidocaine spray for pharyngeal local anesthesia in upper gastroesophageal endoscopy

Abstract

Background:Advantage of using local sedation during upper gastrointestinal endoscopy (UGE) is still challenging. In the current study, the effect of lidocaine spray versus lidocaine viscous solution for pharyngeal local anesthesia during UGE has been compared.Materials and Methods:This is a randomized clinical trial conducted on 130 patients conducting UGE in 2013. Patients were randomly divided into two groups of viscous lidocaine solution (Group V) and lidocaine spray (Group S). Patients’ tolerance, satisfaction, pain/discomfort, and anxiety (based on 11-point numerical score scale) and ease of endoscopy were compared.Results:Ease of procedure, patients’ tolerance, and patients’ satisfaction were not statistically different between two groups (P > 0.05). Patients’ pain/discomfort and anxiety during endoscopy were significantly different between groups (P < 0.05).Conclusion:As a conclusion, there was not any difference between two groups except for pain, discomfort, and anxiety that was higher in those who administered spray that might be due to the method of usage.

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

“…Endoscopes must be inserted through the mouth and this leads to patient anxiety, discomfort, coughing, and gagging, which may make the experience all together unpleasant. 5,6,[11][12][13][17][18][19][20][21][22][23][24][25] Intravenous anesthesia is an option for EGD but holds the risk of adverse events such as bradycardia, hypotension, and respiratory depression, particularly when administered by non-anesthetists. 26,27,[30][31][32][33] The use of topical pharyngeal anesthesia reduced the use and risk of intravenous sedation and directed researcher's attention towards alleviating the gag reflex, pain, discomfort, and improving tolerability of unsedated patients and towards studies to ascertain how to improve tolerability.…”

“…Many publications report the use of different local anesthetic preparations such as viscous lidocaine solution, 17,18 lozenges, 19,20 lollipops, 21 and nebulized…”

“…Several studies have demonstrated that lidocaine spray is superior to other anesthetic formulations. [17][18][19]22 We chose to include the endoscopists' satisfaction as a parameter because the study design included an endoscopic procedure performed by a single blinded operator with an overview of the overall procedure, which was evaluated using NRS. A prior study evaluated the endoscopist's satisfaction using a visual analog scale (VAS: 0 (very unsatisfied) to 10).…”

“…However, it is still unclear which technique is optimal in terms of its influence on the gag reflex, patient tolerability, and pain. [17][18][19][20][21][22] A recent study demonstrated the effectiveness of using ice for topical anesthesia of the oral mucosa compared to lidocaine 5% gel dental injection. 23 The ice popsicle is a famous dessert in Thailand due to the hot weather and led us to the idea of using this for delivering lidocaine.…”

Anesthesia for GI endoscopy in the era of COVID-19

“…[ 17 ] Both lidocaine spray and viscous lidocaine solution are equally effective with regards to ease of procedure, patients' tolerance, and patients' satisfaction in the performance of unsedated gastroscopy. [ 18 ]…”