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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2014; 05(02): 058-063
DOI: 10.4103/0976-5042.144829
Original Article
Society of Gastrointestinal Endoscopy of India

Lidocaine lozenges for pharyngeal anesthesia during upper gastrointestinal endoscopy: A randomized controlled trial

Avinash Supe
Lokmanya Tilak Municipal General Hospital and Medical College, Sion, Mumbai, Maharashtra,
,
Sanjiv P. Haribhakti
1   Kaizen Hospital, A Unit of G.I. Healthcare Pvt, Ltd., Memnagar
,
Mohammad Ali
2   Department of Medical Gasteroenterology and Hepatology, Madras Medical College and Government General Hospital,
,
A. Rathnaswami
3   Department of Surgical Gastroenterology, SRM Medical College Hospital and Research Centre, SRM Nagar, Kattankulathur, Potheri, Chennai, Tamil Nadu,
,
T. Zameer Ulla
4   Department of General Surgery, S.S Institute of Medical Sciences and Research, Davangere, Karnataka, India
,
SanjayKumar H. Maroo
5   Department of Medical Services
,
Ketan R. Patel
6   Department of Research and Development, Troikaa Pharmaceuticals Ltd, Ahmedabad, Gujarat,
› Author Affiliations
Further Information

Publication History

Publication Date:
26 September 2019 (online)

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Abstract

Background and Objectives: A novel lozenge formulation with advantages of ease of drug administration, palatable taste and improved patient compliance could be the preferred mode of topical pharyngeal anesthesia during upper gastrointestinal endoscopy (UGE). This randomized, open-label, active-controlled study was conducted to evaluate the efficacy and safety of lidocaine lozenges versus lidocaine spray in the diagnostic gastroduodenal endoscopy in Indian patients. Subjects and Methods: Two hundred and forty-seven patients of either sex (18-80 years) undergoing diagnostic gastroduodenal endoscopy were randomized either to; lidocaine lozenge 200 mg or lidocaine spray 200 mg to be applied as a single dose before gastroduodenal endoscopy. Ease of procedure, level of gag reflex, ease of application of the local anesthetic, and investigators global assessment were the primary efficacy endpoints. Need for rescue medication and patient’s global assessment were secondary efficacy endpoints. The incidence of any adverse event was the safety endpoint. Between groups, comparison was done by using appropriate statistical test. Results: Investigator reported significantly lesser procedural difficulty (P = 0.0007) and suppressed gag reflex (P < 0.0001) during UGE with lidocaine lozenge compared to spray. Ease of application of local anesthetic was reported easy in significantly more patients as compared with lidocaine spray (P = 0.001). Global assessment by patient and physician was favorable toward lozenge. Incidences of adverse events were similar in both the groups. Conclusions: The study suggests that lidocaine lozenges are an easier way of applying local oropharyngeal anesthesia, produces better suppression of gag reflex and makes the procedure easier when compared with lidocaine spray.

Key words

Gastroduodenal endoscopy - lidocaine lozenge - lidocaine spray - upper gastrointestinal endoscopy
 

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