Bupivacaine Lozenge Compared with Lidocaine Spray as Topical Pharyngeal Anesthetic before Unsedated Upper Gastrointestinal Endoscopy: A Randomized, Controlled Trial

TY - JOUR

T1 - Bupivacaine Lozenge Compared with Lidocaine Spray as Topical Pharyngeal Anesthetic before Unsedated Upper Gastrointestinal Endoscopy

T2 - A Randomized, Controlled Trial

AU - Salale, Nesrin

AU - Treldal, Charlotte

AU - Mogensen, Stine

AU - Rasmussen, Mette

AU - Petersen, Janne

AU - Andersen, Ove

AU - Jacobsen, Jette

PY - 2014/10/4

Y1 - 2014/10/4

N2 - Unsedated upper gastrointestinal endoscopy (UGE) can induce patient discomfort, mainly due to a strong gag reflex. The aim was to assess the effect of a bupivacaine lozenge as topical pharyngeal anesthetic compared with standard treatment with a lidocaine spray before UGE. Ninety-nine adult outpatients undergoing unsedated diagnostic UGE were randomized to receive either a bupivacaine lozenge (L-group, n = 51) or lidocaine spray (S-group, n = 42). Primary objective was assessment of patient discomfort including acceptance of the gag reflex during UGE. The L-group assessed the discomfort significantly lower on a visual analog scale compared with the S-group (P = 0.02). There was also a significant difference in the four-point scale assessment of the gag reflex (P = 0.03). It was evaluated as acceptable by 49% in the L-group compared with 31% in the S-group. A bupivacaine lozenge compared with a lidocaine spray proved to be a superior option as topical pharyngeal anesthetic before an UGE.

AB - Unsedated upper gastrointestinal endoscopy (UGE) can induce patient discomfort, mainly due to a strong gag reflex. The aim was to assess the effect of a bupivacaine lozenge as topical pharyngeal anesthetic compared with standard treatment with a lidocaine spray before UGE. Ninety-nine adult outpatients undergoing unsedated diagnostic UGE were randomized to receive either a bupivacaine lozenge (L-group, n = 51) or lidocaine spray (S-group, n = 42). Primary objective was assessment of patient discomfort including acceptance of the gag reflex during UGE. The L-group assessed the discomfort significantly lower on a visual analog scale compared with the S-group (P = 0.02). There was also a significant difference in the four-point scale assessment of the gag reflex (P = 0.03). It was evaluated as acceptable by 49% in the L-group compared with 31% in the S-group. A bupivacaine lozenge compared with a lidocaine spray proved to be a superior option as topical pharyngeal anesthetic before an UGE.

U2 - 10.4137/CGast.S18019

DO - 10.4137/CGast.S18019

M3 - Journal article

C2 - 25374463

SN - 1179-5522

VL - 7

SP - 55

EP - 59

JO - Clinical Medicine Insights: Gastroenterology

JF - Clinical Medicine Insights: Gastroenterology

ER -