Topical Pharyngeal Anesthesia Improves Tolerance of Upper Gastrointestinal Endoscopy: A Randomized Double-Blind Study

Campo, Rafel; Brullet, Enric; Montserrat, A.; Calvet, Xavier; Rivero, E.; Brotons, Carlos

doi:10.1055/s-2007-1005783

Cited by 50 publications

(24 citation statements)

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“…In Hong Kong, 10% Xylocaine pump spray (AstraZeneca, Sodertalje, Sweden) is the pharyngeal anesthesia generally used as a premedication in unsedated EGD. However it carries a bitter taste [1], and there is controversial scientific evidence concerning its efficacy in improving patients' tolerance for the procedure [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Flavored anesthetic lozenge versus Xylocaine spray used as topical pharyngeal anesthesia for unsedated esophagogastroduodenoscopy: a randomized placebo-controlled trial

2009

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Section: Introductionmentioning

confidence: 99%

Flavored anesthetic lozenge versus Xylocaine spray used as topical pharyngeal anesthesia for unsedated esophagogastroduodenoscopy: a randomized placebo-controlled trial

2009

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“…12 Usefulness of a topical pharyngeal anesthetic is controversial although it is commonly used before gastroscopy. 13,14 UK data show that topical pharyngeal anesthetics are always used in 63%, sometimes in 17%, and not used in 20% of all cases. 15 Because topical pharyngeal anesthesia does not affect patient tolerance and procedure performance in patients receiving conscious sedation, 16,17 pharyngeal anesthetics can be omitted when potential risk of allergic shock is considered.…”

Section: Edicalmentioning

confidence: 99%

“…13,14 UK data show that topical pharyngeal anesthetics are always used in 63%, sometimes in 17%, and not used in 20% of all cases.…”

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confidence: 99%

Basic principles and practice of gastric cancer screening using high‐definition white‐light gastroscopy: Eyes can only see what the brain knows

Gotoda

Uedo

Yoshinaga³

et al. 2016

Digestive Endoscopy

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Endoscopic diagnosis of gastrointestinal tumors consists of the following processes: (i) detection; (ii) differential diagnosis; and (iii) quantitative diagnosis (size and depth) of a lesion. Although detection is the first step to make a diagnosis of the tumor, the lesion can be overlooked if an endoscopist has no knowledge of what an earlystage 'superficial lesion' looks like. In recent years, image-enhanced endoscopy has become common, but white-light endoscopy (WLI) is still the first step for detection and characterization of lesions in general clinical practice. Settings and practice of routine esophagogastroduodenoscopy (EGD) such as use of antispasmodics, number of endoscopic images taken, and observational procedure are customarily decided in each facility in each country and are not well standardized. Therefore, in the present article, we attempted to outline currently available evidence and actual Japanese practice on gastric cancer screening using WLI, and provide tips for detecting EGC during routine EGD which could become the basis of future research.Key words: gastric atrophy, gastric cancer, Helicobacter pylori, Kimura-Takemoto classification, screening gastroscopy MEDICAL INTERVIEW PRIOR TO ESOPHAGOGASTRODUODENOSCOPY M EDICALINTERVIEW BEFORE esophagogastroduodenoscopy (EGD) is important in terms of the following two points. One is to confirm indication of the EGD and the other is to assess risk of examinees. Whether indication for EGD is to screen for early gastric cancer (EGC) or to make a diagnosis of a patient's symptoms or abnormal findings in other diagnostic examinations should be distinguished. In the screening endoscopy, the entire gastric mucosa is thoroughly observed to detect any suspicious findings for neoplasia, whereas only the presence of apparent lesions that may cause symptoms or abnormal image findings are investigated. Although endoscopy is usually intended to make a diagnosis of symptoms or abnormal findings in other diagnostic images, EGC are often found in patients with neither obvious symptoms nor abnormal findings in other diagnostic tests.1 Therefore, in high-risk patients, it is important to screen for EGC unrelated to symptoms or abnormal find-ings of other diagnostic tests during EGD. The examinee should be asked about status and history of eradication therapy of Helicobacter pylori (H. pylori), 2-4 family history of gastric cancer, smoking and drinking habits. [5][6][7][8] Another reason for the medical interview is to reduce 10 and an anti-foaming agent 11 reduces time and effort for washing out mucus or bubbles to improve quality of observation. A mixture of 4 mL anti-foaming agent (dimethicone, Gascon ® 20 mg/mL; Horii Pharmaceutical Industry, Osaka Japan), 20 000 U mucolytic agent (Pronase MS ® ; Kaken Pharmaceutical, Tokyo, Japan), and 1 g sodium bicarbonate dissolved in 50 mL water is given 10 min before the examination. 12Usefulness of a topical pharyngeal anesthetic is controversial although it is commonly used before gastroscopy. 13,14 UK data show that to...

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“…This is less traumatic than the old technique of blind intubation, but requires an absent cough reflex if the larynx is to be viewed easily. Pharyngeal anaesthesia enables endoscopy to be accomplished more easily [9,10,11]. This applies to sedated as well as unsedated patients according to a recent meta-analysis [12].…”

Section: Does Local Anaesthetic Throat Spray Help In Upper Digestive mentioning

confidence: 99%

Throat Spray, Sedation or Anaesthetic?

Axon¹

2010

Digestion

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Digestive endoscopy covers a wide variety of procedures; the need for sedation is governed by the invasiveness and length of the procedure, the wishes of the patient, the desire of the operator for a compliant patient, and safety. Many patients are prepared to undergo upper digestive endoscopy using throat spray without sedation, while fewer accept unsedated colonoscopy. There are clinical advantages as well as disadvantages in employing sedation and sometimes general anaesthesia is the preferred option. This paper provides an introduction to the choices available and the approaches that are employed in endoscopic sedation practice.

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Topical Pharyngeal Anesthesia Improves Tolerance of Upper Gastrointestinal Endoscopy: A Randomized Double-Blind Study

Abstract: Topical pharyngeal anesthesia in unsedated patients undergoing diagnostic upper gastrointestinal endoscopy improves tolerance and makes examination easier.

Cited by 50 publications

References 0 publications

Flavored anesthetic lozenge versus Xylocaine spray used as topical pharyngeal anesthesia for unsedated esophagogastroduodenoscopy: a randomized placebo-controlled trial

Flavored anesthetic lozenge versus Xylocaine spray used as topical pharyngeal anesthesia for unsedated esophagogastroduodenoscopy: a randomized placebo-controlled trial

Basic principles and practice of gastric cancer screening using high‐definition white‐light gastroscopy: Eyes can only see what the brain knows

Throat Spray, Sedation or Anaesthetic?

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