Lidocaine versus lidocaine plus benzydamine as a topical anesthesia regimen for unsedated upper gastrointestinal endoscopy: A comparison study

Abstract

Background/Aims: The aim was to assess the efficacy of adding benzydamine (B) spray to standard treatment with a lidocaine (L) spray before upper gastrointestinal endoscopy (UGE) as a topical anaesthetic regimen. Materials and Methods: A total of 118 adult patients undergoing outpatient UGE were randomly assigned to receive L (n=44), LB (n=38) or B (n=36) before the procedure. The primary outcome was the patient tolerance score, which represents a summative evaluation of the taste of the anesthetic agent, the intensity of pharyngeal numbness, the amount of coughing or gagging and the degree of discomfort during oesophageal intubation. Results: The median (min-max) patient tolerance scores were comparable between groups LB (10.5; range 5-12) and L (10; range 4-13) (p=0.235) and significantly lower in group B (7.5; range 3-12) (p<0.01). LB improved several secondary outcomes. Oesophageal intubation was less difficult (5 [range 2-10] vs 3 [range 0-8], p<0.001), and a lower proportion of patients developed postprocedural sore throat (4 [10.5%] vs 15 [34.1%], p=0.011) in LB compared to L. Conclusion: LB is not superior to L in terms of overall patient tolerance, but LB may be preferred over L in cases with difficult oesophageal intubation or a previous history of postprocedural sore throat.

Topical pharyngeal anesthesia provides no additional benefit to propofol sedation for esophagogastroduodenoscopy: a randomized controlled double-blinded clinical trial

“…This was not done because the percentage of patients with severe discomfort was very low. Third, lidocaine was used for topical anesthesia in this study because lidocaine is commonly used in clinical practice, while previous studies also compared other medications for topical anesthesia 20 – 22 , which may be further assessed in future.…”

Investigation of Efficacy of Lidocaine Spray for Sedated Esophagogastroduodenoscopy in Children

“…Our data show that there is less increase in oral secretion in the LS group (9.3%) compared to the DS group (51.7%), compatible with the literature ( p =0.038). In a study done in our country comparing sore throat, sore throat was observed the least in the lidocaine benzydamine group in the comparison of lidocaine spray, lidocaine benzydamine spray and benzydamine spray, while it was observed the most in the benzydamine group [18]. In our study, sore throat was observed to a significantly lesser degree in the LS group (3.7%) compared to the DS group (35.6%) compatible with the literature ( p =0.019).…”

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

“…[10] This procedure can be irritating for patients in case of not using sedatives due to gag reflex stimulation. [2] UGE without using sedatives has some advantages including lower incidence of cardiopulmonary complications, shorter duration of procedure, fewer costs, and patients’ ability of controlling self-care after endoscopy. [1112] On the other hand, sedation can cause better tolerance and less irritation for patients.…”

“…as well regarding patients’ tolerance while spray plus benzydamine was accompanied with less sore throat and easier esophageal intubation. [2] It should be noted that less sore throat may have occurred because of local anti-inflammatory effect of benzydamine regardless of lidocaine spray.…”

“…Upper gastrointestinal endoscopy (UGE) is a common minimally invasive procedure used widely for the diagnosis of malignant or benign conditions of gastrointestinal (GI) tract and is a safe means of operating therapeutic procedures. [12]…”