BACKGROUND: Conscious sedation is usually achieved during EGD by a combination of intravenous benzodiazepines and opiates; however, these have potential serious adverse effects. The addition of topical oropharyngeal anesthetics such as lidocaine may be useful. Recent data suggest that the administration of topical lidocaine by means of a lollipop is effective for endotracheal intubation and bronchoscopy. OBJECTIVE: Our purpose was to evaluate the safety and efficacy of a lidocaine lollipop as single-agent anesthesia for EGD and to determine whether its use reduces the need for intravenous sedatives and analgesics. DESIGN: Single-blinded, randomized, prospective study. SETTING:University hospital. PATIENTS: 50 patients undergoing diagnostic EGD. INTERVENTIONS: Patients were randomized to either lidocaine lollipop or lidocaine spray. Intravenous meperidine and midazolam were administered during the procedure as needed. MAIN OUTCOME MEASUREMENTS: The success and safety of local anesthesia by lidocaine lollipop in addition to the need for intravenous sedation. RESULTS: Patients were equally randomized between the lollipop and the spray groups. The lollipop group had less gag reflex, accommodated scope introduction more, and tolerated the procedure better. Thirty-two percent of patients receiving the lollipop required sedation compared with 96% of patients in the spray group (P < .001). The majority in the lollipop group were satisfied with their mode of anesthesia compared with the spray group. CONCLUSIONS:Lidocaine lollipop is a promising form of local oropharyngeal anesthesia for EGD. Its use resulted in sparing the use of intravenous sedation. It is well tolerated and safe and may be particularly important in the elderly, patients with comorbidities, and office-based endoscopy.
RCT Entities:
BACKGROUND: Conscious sedation is usually achieved during EGD by a combination of intravenous benzodiazepines and opiates; however, these have potential serious adverse effects. The addition of topical oropharyngeal anesthetics such as lidocaine may be useful. Recent data suggest that the administration of topical lidocaine by means of a lollipop is effective for endotracheal intubation and bronchoscopy. OBJECTIVE: Our purpose was to evaluate the safety and efficacy of a lidocaine lollipop as single-agent anesthesia for EGD and to determine whether its use reduces the need for intravenous sedatives and analgesics. DESIGN: Single-blinded, randomized, prospective study. SETTING: University hospital. PATIENTS: 50 patients undergoing diagnostic EGD. INTERVENTIONS:Patients were randomized to either lidocaine lollipop or lidocaine spray. Intravenous meperidine and midazolam were administered during the procedure as needed. MAIN OUTCOME MEASUREMENTS: The success and safety of local anesthesia by lidocaine lollipop in addition to the need for intravenous sedation. RESULTS:Patients were equally randomized between the lollipop and the spray groups. The lollipop group had less gag reflex, accommodated scope introduction more, and tolerated the procedure better. Thirty-two percent of patients receiving the lollipop required sedation compared with 96% of patients in the spray group (P < .001). The majority in the lollipop group were satisfied with their mode of anesthesia compared with the spray group. CONCLUSIONS:Lidocaine lollipop is a promising form of local oropharyngeal anesthesia for EGD. Its use resulted in sparing the use of intravenous sedation. It is well tolerated and safe and may be particularly important in the elderly, patients with comorbidities, and office-based endoscopy.
Authors: Assaad M Soweid; Shadi R Yaghi; Faek R Jamali; Abdallah A Kobeissy; Michella E Mallat; Rola Hussein; Chakib M Ayoub Journal: World J Gastroenterol Date: 2011-12-21 Impact factor: 5.742
Authors: Moisés Ortega Ramírez; Benigno Linares Segovia; Marco Antonio García Cuevas; Jorge Luis Sánchez Romero; Illich Botello Buenrostro; Norma Amador Licona; Juan Manuel Guízar Mendoza; Jesús Francisco Guerrero Romero; Víctor Manuel Vázquez Zárate Journal: Gastroenterol Res Pract Date: 2013-03-05 Impact factor: 2.260