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

• Published in: The Turkish journal of gastroenterology Vol. 26; no. 3; pp. 224 - 227
• Main Authors: İbiş, Mehmet, Arhan, Mehmet, İbiş, Tuba, Önal, İbrahim Koral, Erdal, Harun, Utku, Özlem Gül
• Format: Journal Article
• Language: English
• Published: Turkey 01.05.2015
• Subjects: Administration, Topical; Adult; Anesthesia, Local - methods; Anesthesia, Local - psychology; Anesthetics, Combined - administration & dosage; Anesthetics, Local - administration & dosage; Anti-Inflammatory Agents - administration & dosage; Benzydamine - administration & dosage; Endoscopy, Gastrointestinal - methods; Esophagus; Female; Humans; Intubation, Gastrointestinal - adverse effects; Lidocaine - administration & dosage; Male; Middle Aged; Patient Satisfaction; Pharynx
• ISSN: 1300-4948; 2148-5607
• DOI: 10.5152/tjg.2015.0090

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. 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. 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. 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.