Lidocaine spray alone is similar to spray plus viscous solution for pharyngeal observation during transoral endoscopy: a clinical randomized trial
Background and study aims It is important to examine the pharynx during upper gastrointestinal endoscopy. Pharyngeal anesthesia using topical lidocaine is generally used as pretreatment. In Japan, lidocaine viscous solution is the anestheti...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2017-01-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-120414 |
| _version_ | 1828177663207931904 |
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| author | Tomoyuki Hayashi Yoshiro Asahina Yohei Waseda Kazuya Kitamura Takashi Kagaya Takuya Seike Kazuhiro Okada Yuki Inada Hisashi Takabatake Noriaki Orita Yuko Yanase Tatsuya Yamashita Itasu Ninomiya Kenichi Yoshimura Shuichi Kaneko |
| author_facet | Tomoyuki Hayashi Yoshiro Asahina Yohei Waseda Kazuya Kitamura Takashi Kagaya Takuya Seike Kazuhiro Okada Yuki Inada Hisashi Takabatake Noriaki Orita Yuko Yanase Tatsuya Yamashita Itasu Ninomiya Kenichi Yoshimura Shuichi Kaneko |
| author_sort | Tomoyuki Hayashi |
| collection | DOAJ |
| description | Background and study aims It is important to examine the pharynx during
upper gastrointestinal endoscopy. Pharyngeal anesthesia using topical lidocaine
is generally used as pretreatment. In Japan, lidocaine viscous solution is the
anesthetic of choice, but lidocaine spray is applied when the former is
considered insufficient. However, the relationship between the extent of
pharyngeal anesthesia and accuracy of observation is unclear. We compared the
performance of lidocaine spray alone versus lidocaine spray combined with
lidocaine viscous solution for pharyngeal observation during transoral
endoscopy.
Patients and methods In this prospective, double-blinded, randomized
clinical trial conducted between January and March 2015, 327 patients were
randomly assigned to lidocaine spray alone (spray group, n = 157) or a
combination of spray and viscous solution (combination group, n = 170). We
compared the number of pharyngeal observable sites (non-inferiority test), pain
by visual analogue scale, observation time, and the number of gag reflexes
between the two groups.
Results The mean number of images of suitable quality taken at the
observable pharyngeal sites in the spray group was 8.33 (95 % confidence
interval [CI]: 7.94 – 8.72) per patient, and 8.77 (95 % CI: 8.49 – 9.05) per
patient in the combination group. The difference in the number of observable
pharyngeal sites was – 0.44 (95 % CI: – 0.84 to – 0.03, P = 0.01). There
were no differences in pain, observation time, or number of gag reflexes between
the 2 groups. Subgroup analysis of the presence of sedation revealed no
differences between the two groups for the number of pharyngeal observation
sites and the number of gag reflexes. However, the number of gag reflexes was
higher in the spray group compared to the combination group in a subgroup
analysis that looked at the absence of sedation.
Conclusions Lidocaine spray for pharyngeal anesthesia was not inferior to
lidocaine spray and viscous solution in terms of pharyngeal observation. It was
considered that lidocaine viscous solution was unnecessary for pharyngeal
observation. UMIN000016073 |
| first_indexed | 2024-04-12T05:01:44Z |
| format | Article |
| id | doaj.art-cb2ec27eff90452caaaf06466f6b87df |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-12T05:01:44Z |
| publishDate | 2017-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-cb2ec27eff90452caaaf06466f6b87df2022-12-22T03:46:59ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362017-01-010501E47E5310.1055/s-0042-120414Lidocaine spray alone is similar to spray plus viscous solution for pharyngeal observation during transoral endoscopy: a clinical randomized trialTomoyuki Hayashi0Yoshiro Asahina1Yohei Waseda2Kazuya Kitamura3Takashi Kagaya4Takuya Seike5Kazuhiro Okada6Yuki Inada7Hisashi Takabatake8Noriaki Orita9Yuko Yanase10Tatsuya Yamashita11Itasu Ninomiya12Kenichi Yoshimura13Shuichi Kaneko14Department of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastrointestinal Surgery, Kanazawa University Hospital, Ishikawa, JapanInnovative Clinical Research Center, Kanazawa University Hospital, Ishikawa, JapanDepartment of Gastroenterology, Kanazawa University Hospital, Ishikawa, JapanBackground and study aims It is important to examine the pharynx during upper gastrointestinal endoscopy. Pharyngeal anesthesia using topical lidocaine is generally used as pretreatment. In Japan, lidocaine viscous solution is the anesthetic of choice, but lidocaine spray is applied when the former is considered insufficient. However, the relationship between the extent of pharyngeal anesthesia and accuracy of observation is unclear. We compared the performance of lidocaine spray alone versus lidocaine spray combined with lidocaine viscous solution for pharyngeal observation during transoral endoscopy. Patients and methods In this prospective, double-blinded, randomized clinical trial conducted between January and March 2015, 327 patients were randomly assigned to lidocaine spray alone (spray group, n = 157) or a combination of spray and viscous solution (combination group, n = 170). We compared the number of pharyngeal observable sites (non-inferiority test), pain by visual analogue scale, observation time, and the number of gag reflexes between the two groups. Results The mean number of images of suitable quality taken at the observable pharyngeal sites in the spray group was 8.33 (95 % confidence interval [CI]: 7.94 – 8.72) per patient, and 8.77 (95 % CI: 8.49 – 9.05) per patient in the combination group. The difference in the number of observable pharyngeal sites was – 0.44 (95 % CI: – 0.84 to – 0.03, P = 0.01). There were no differences in pain, observation time, or number of gag reflexes between the 2 groups. Subgroup analysis of the presence of sedation revealed no differences between the two groups for the number of pharyngeal observation sites and the number of gag reflexes. However, the number of gag reflexes was higher in the spray group compared to the combination group in a subgroup analysis that looked at the absence of sedation. Conclusions Lidocaine spray for pharyngeal anesthesia was not inferior to lidocaine spray and viscous solution in terms of pharyngeal observation. It was considered that lidocaine viscous solution was unnecessary for pharyngeal observation. UMIN000016073http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-120414 |
| spellingShingle | Tomoyuki Hayashi Yoshiro Asahina Yohei Waseda Kazuya Kitamura Takashi Kagaya Takuya Seike Kazuhiro Okada Yuki Inada Hisashi Takabatake Noriaki Orita Yuko Yanase Tatsuya Yamashita Itasu Ninomiya Kenichi Yoshimura Shuichi Kaneko Lidocaine spray alone is similar to spray plus viscous solution for pharyngeal observation during transoral endoscopy: a clinical randomized trial Endoscopy International Open |
| title | Lidocaine
spray alone is similar to spray plus viscous solution for pharyngeal observation
during transoral endoscopy: a clinical randomized
trial |
| title_full | Lidocaine
spray alone is similar to spray plus viscous solution for pharyngeal observation
during transoral endoscopy: a clinical randomized
trial |
| title_fullStr | Lidocaine
spray alone is similar to spray plus viscous solution for pharyngeal observation
during transoral endoscopy: a clinical randomized
trial |
| title_full_unstemmed | Lidocaine
spray alone is similar to spray plus viscous solution for pharyngeal observation
during transoral endoscopy: a clinical randomized
trial |
| title_short | Lidocaine
spray alone is similar to spray plus viscous solution for pharyngeal observation
during transoral endoscopy: a clinical randomized
trial |
| title_sort | lidocaine spray alone is similar to spray plus viscous solution for pharyngeal observation during transoral endoscopy a clinical randomized trial |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-120414 |
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