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

Prasit Mahawongkajit,1 Nantawat Talalak,1 Neranchala Soonthornkes2 1Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, 12120, Thailand; 2Department of Anesthesiology, Faculty of Medicine, Thammasat University, Pathumthani, 12120, ThailandCorrespondence: Prasit Mahawongkaj...

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Main Authors: Mahawongkajit P, Talalak N, Soonthornkes N
Format: Article
Language:English
Published: Dove Medical Press 2021-05-01
Series:Clinical and Experimental Gastroenterology
Subjects:
Online Access:https://www.dovepress.com/comparison-of-lidocaine-spray-and-lidocaine-ice-popsicle-in-patients-u-peer-reviewed-fulltext-article-CEG
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author Mahawongkajit P
Talalak N
Soonthornkes N
author_facet Mahawongkajit P
Talalak N
Soonthornkes N
author_sort Mahawongkajit P
collection DOAJ
description Prasit Mahawongkajit,1 Nantawat Talalak,1 Neranchala Soonthornkes2 1Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, 12120, Thailand; 2Department of Anesthesiology, Faculty of Medicine, Thammasat University, Pathumthani, 12120, ThailandCorrespondence: Prasit MahawongkajitDepartment of Surgery, Faculty of Medicine, Thammasat University (Rangsit Campus), 99/209 Moo 18, Paholyothin Road, Amphur Klongluang, Pathumthani, 12120, ThailandTel +66 2926 9523Fax +66 2926 9530Email prasit_md@yahoo.comPurpose: Esophagogastroduodenoscopy (EGD) under topical pharyngeal anesthesia has the advantage of avoiding the unwanted cardiopulmonary adverse events experienced following intravenous sedation. Lidocaine spray is a common anesthetic option and is safe for unsedated EGD. Although several studies have compared different topical anesthetic agents, their formulations, and delivery techniques, questions still remain concerning the optimal mode of administration. We have designed a lidocaine formulation in the form of an ice popsicle and compared its effectiveness and tolerability with lidocaine spray in patients undergoing unsedated EGD.Methods: This was a single-center prospective randomized controlled trial. Unsedated EGD patients were randomly allocated the lidocaine spray [Group (Gp) A] or lidocaine ice popsicle (Gp B) formulation.Results: In total, 204 unsedated EGD patients were evaluated. Compared to the spray, the lidocaine ice popsicle group showed better scores for effects in terms of endoscopist satisfaction (Gp A, 7.28± 1.44; Gp B, 7.8± 0.89; p=0.0022), gag reflex (Gp A, 1.3± 0.66; Gp B, 1.02± 0.61; p=0.0016), patient satisfaction (Gp A, 7.74± 0.82; Gp B, 8.08± 0.82; p=0.0039), discomfort (Gp A, 6.54± 1.34; Gp B, 5.95± 1.21; p=0.0012), and pain (Gp A, 5.38± 1.85; Gp B, 4.51± 2.01; p=0.0015).Conclusion: Both the lidocaine spray and ice popsicle formulations are safe, effective options for diagnostic EGD with the ice popsicle exhibiting better performance. We propose the lidocaine ice popsicle formulation for topical pharyngeal anesthesia in patients undergoing unsedated diagnostic EGD and suggest it may be a suitable option during the COVID-19 pandemic.Clinical Trial Register: Thai Clinical Trials Registry (TCTR) number TCTR20190502001.Keywords: lidocaine spray, lidocaine ice popsicle, esophagogastroduodenoscopy, upper gastrointestinal endoscopy, topical pharyngeal anesthesia
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spelling doaj.art-701b98d57d88412e8303400124af14fc2022-12-21T18:29:26ZengDove Medical PressClinical and Experimental Gastroenterology1178-70232021-05-01Volume 1420921665170Comparison of Lidocaine Spray and Lidocaine Ice Popsicle in Patients Undergoing Unsedated Esophagogastroduodenoscopy: A Single Center Prospective Randomized Controlled TrialMahawongkajit PTalalak NSoonthornkes NPrasit Mahawongkajit,1 Nantawat Talalak,1 Neranchala Soonthornkes2 1Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, 12120, Thailand; 2Department of Anesthesiology, Faculty of Medicine, Thammasat University, Pathumthani, 12120, ThailandCorrespondence: Prasit MahawongkajitDepartment of Surgery, Faculty of Medicine, Thammasat University (Rangsit Campus), 99/209 Moo 18, Paholyothin Road, Amphur Klongluang, Pathumthani, 12120, ThailandTel +66 2926 9523Fax +66 2926 9530Email prasit_md@yahoo.comPurpose: Esophagogastroduodenoscopy (EGD) under topical pharyngeal anesthesia has the advantage of avoiding the unwanted cardiopulmonary adverse events experienced following intravenous sedation. Lidocaine spray is a common anesthetic option and is safe for unsedated EGD. Although several studies have compared different topical anesthetic agents, their formulations, and delivery techniques, questions still remain concerning the optimal mode of administration. We have designed a lidocaine formulation in the form of an ice popsicle and compared its effectiveness and tolerability with lidocaine spray in patients undergoing unsedated EGD.Methods: This was a single-center prospective randomized controlled trial. Unsedated EGD patients were randomly allocated the lidocaine spray [Group (Gp) A] or lidocaine ice popsicle (Gp B) formulation.Results: In total, 204 unsedated EGD patients were evaluated. Compared to the spray, the lidocaine ice popsicle group showed better scores for effects in terms of endoscopist satisfaction (Gp A, 7.28± 1.44; Gp B, 7.8± 0.89; p=0.0022), gag reflex (Gp A, 1.3± 0.66; Gp B, 1.02± 0.61; p=0.0016), patient satisfaction (Gp A, 7.74± 0.82; Gp B, 8.08± 0.82; p=0.0039), discomfort (Gp A, 6.54± 1.34; Gp B, 5.95± 1.21; p=0.0012), and pain (Gp A, 5.38± 1.85; Gp B, 4.51± 2.01; p=0.0015).Conclusion: Both the lidocaine spray and ice popsicle formulations are safe, effective options for diagnostic EGD with the ice popsicle exhibiting better performance. We propose the lidocaine ice popsicle formulation for topical pharyngeal anesthesia in patients undergoing unsedated diagnostic EGD and suggest it may be a suitable option during the COVID-19 pandemic.Clinical Trial Register: Thai Clinical Trials Registry (TCTR) number TCTR20190502001.Keywords: lidocaine spray, lidocaine ice popsicle, esophagogastroduodenoscopy, upper gastrointestinal endoscopy, topical pharyngeal anesthesiahttps://www.dovepress.com/comparison-of-lidocaine-spray-and-lidocaine-ice-popsicle-in-patients-u-peer-reviewed-fulltext-article-CEGlidocaine spraylidocaine ice popsicleesophagogastroduodenoscopyupper gastrointestinal endoscopytopical pharyngeal anesthesia
spellingShingle Mahawongkajit P
Talalak N
Soonthornkes N
Comparison of Lidocaine Spray and Lidocaine Ice Popsicle in Patients Undergoing Unsedated Esophagogastroduodenoscopy: A Single Center Prospective Randomized Controlled Trial
Clinical and Experimental Gastroenterology
lidocaine spray
lidocaine ice popsicle
esophagogastroduodenoscopy
upper gastrointestinal endoscopy
topical pharyngeal anesthesia
title Comparison of Lidocaine Spray and Lidocaine Ice Popsicle in Patients Undergoing Unsedated Esophagogastroduodenoscopy: A Single Center Prospective Randomized Controlled Trial
title_full Comparison of Lidocaine Spray and Lidocaine Ice Popsicle in Patients Undergoing Unsedated Esophagogastroduodenoscopy: A Single Center Prospective Randomized Controlled Trial
title_fullStr Comparison of Lidocaine Spray and Lidocaine Ice Popsicle in Patients Undergoing Unsedated Esophagogastroduodenoscopy: A Single Center Prospective Randomized Controlled Trial
title_full_unstemmed Comparison of Lidocaine Spray and Lidocaine Ice Popsicle in Patients Undergoing Unsedated Esophagogastroduodenoscopy: A Single Center Prospective Randomized Controlled Trial
title_short Comparison of Lidocaine Spray and Lidocaine Ice Popsicle in Patients Undergoing Unsedated Esophagogastroduodenoscopy: A Single Center Prospective Randomized Controlled Trial
title_sort comparison of lidocaine spray and lidocaine ice popsicle in patients undergoing unsedated esophagogastroduodenoscopy a single center prospective randomized controlled trial
topic lidocaine spray
lidocaine ice popsicle
esophagogastroduodenoscopy
upper gastrointestinal endoscopy
topical pharyngeal anesthesia
url https://www.dovepress.com/comparison-of-lidocaine-spray-and-lidocaine-ice-popsicle-in-patients-u-peer-reviewed-fulltext-article-CEG
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