Meredith B O'Dea1, Susan E Langmore2, Gintas P Krisciunas3, Michael Walsh4, Linsey L Zanchetti5, Rebecca Scheel4, Edel McNally4, Asako Satoh Kaneoka5, Anthony J Guarino6, Susan G Butler7. 1. MGH Institute of Health Professions, Charlestown Navy Yard, Boston, Massachusetts, USA Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts, USA modea1@mghihp.edu. 2. Department of Otolaryngology, Boston University School of Medicine, Boston, Massachusetts, USA Department of Speech Language Hearing Sciences, Boston University, Sargent College, Boston, Massachusetts, USA. 3. Department of Otolaryngology, Boston University School of Medicine, Boston, Massachusetts, USA. 4. Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts, USA. 5. Department of Speech Language Hearing Sciences, Boston University, Sargent College, Boston, Massachusetts, USA. 6. MGH Institute of Health Professions, Center for Interprofessional Studies and Innovation, Boston, Massachusetts, USA. 7. Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Abstract
PURPOSE: The aims of this study were to assess the effects of 0.2 mL of 4% atomized lidocaine on swallowing and tolerability during Fiberoptic Endoscopic Evaluation of Swallowing (FEES). METHODS: A single blinded study was conducted with 17 dysphagic patients, who received 4 standardized boluses in 2 sequential FEES exams under 2 conditions: non-anesthetized (decongestant only) and anesthetized (lidocaine 4%+decongestant). After each procedure, patients rated their pain on the Wong Baker FACES Pain Rating Scale. Clinicians scored each swallow with the Penetration Aspiration Scale (PAS) and an author-developed Residue Rating Scale. Because the assessments were ordinal, a series of Wilcoxon signed-rank tests were conducted to detect differences between the 2 conditions. RESULTS: No significant differences were detected between groups on PAS or residue in the 4 boluses. Pain scores, however, were significantly lower in the anesthetized condition than the decongested-only condition (P=.035). CONCLUSION: The findings of this study indicated that 0.2 mL of 4% lidocaine enhanced exam tolerability and did not impair the swallow in dysphagic patients.
RCT Entities:
PURPOSE: The aims of this study were to assess the effects of 0.2 mL of 4% atomized lidocaine on swallowing and tolerability during Fiberoptic Endoscopic Evaluation of Swallowing (FEES). METHODS: A single blinded study was conducted with 17 dysphagic patients, who received 4 standardized boluses in 2 sequential FEES exams under 2 conditions: non-anesthetized (decongestant only) and anesthetized (lidocaine 4%+decongestant). After each procedure, patients rated their pain on the Wong Baker FACES Pain Rating Scale. Clinicians scored each swallow with the Penetration Aspiration Scale (PAS) and an author-developed Residue Rating Scale. Because the assessments were ordinal, a series of Wilcoxon signed-rank tests were conducted to detect differences between the 2 conditions. RESULTS: No significant differences were detected between groups on PAS or residue in the 4 boluses. Pain scores, however, were significantly lower in the anesthetized condition than the decongested-only condition (P=.035). CONCLUSION: The findings of this study indicated that 0.2 mL of 4% lidocaine enhanced exam tolerability and did not impair the swallow in dysphagic patients.
Authors: Marc Moss; S David White; Heather Warner; Daniel Dvorkin; Daniel Fink; Stephanie Gomez-Taborda; Carrie Higgins; Gintas P Krisciunas; Joseph E Levitt; Jeffrey McKeehan; Edel McNally; Alix Rubio; Rebecca Scheel; Jonathan M Siner; Rosemary Vojnik; Susan E Langmore Journal: Chest Date: 2020-07-25 Impact factor: 9.410
Authors: Ylinne T Lynch; Brendan J Clark; Madison Macht; S David White; Heather Taylor; Tim Wimbish; Marc Moss Journal: J Crit Care Date: 2017-02-15 Impact factor: 3.425