Local anaesthesia of the pharynx for OesophaoGastroDuodenoscopy (OGD); new technique with better patient tolerance and reduced risk of airborne spread

Aims Upper-gastrointestinal endoscopy, or oesophagogastroduodenoscopy (OGD), is a procedure routinely performed in secondary care settings throughout the UK. Local anaesthesia, in the form of throat spray, and intravenous sedation are often used to make this clinical procedure more comfortable for the patient.

Methods This study focused primarily on the difference in administration of the local anaesthetic throat spray. The commonly used method was to spray the back of the patient’s pharynx while their mouth was open: “mouth-open” technique. This study proposed a modified technique which involved spraying the pharynx with the mouth closed around the spray nozzle: “JASMEG” technique. This was a quality improvement study of 474 patients (male: female=1.13) who were undergoing an OGD as part of routine care in a district general hospital in the United Kingdom. It was carried out to investigate whether this new method of spray administration would increase patient comfort and reduce patient anxiety, pulse rate and incidence of cough. Comfort and anxiety scores were scored on a 5-point Liker scale (1=most comfortable/ least anxious, 5=least comfortable/ most anxious). Outcomes were compared between the two groups using linear regression models controlling for sex. Incidence of cough was compared between groups using Fisher’s exact test.

Results A breakdown of the sample by treatment group and sex is shown in Table 1. As compared to the “mouth-open” group, the “JASMEG” group showed a smaller increase in pulse rates (group difference=-3.97, p<0.001), lower anxiety scores (group difference=-1.31, p<0.001), higher comfort scores (group difference=1.07, p<0.001) and lower incidence of cough (13 out of 252 vs 190 out of 222; p<0.001). There were no significant differences in the results by sex.

Conclusions The new “JASMEG” technique of local anaesthetic spray for patients undergoing OGD is superior in terms of patient comfort, anxiety levels, pulse rates and presence of cough. This is alow-cost alternative to reduce transmission of aerosol-transmitted infections, while also making it a more favourable procedure for patients. [1]

 

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Conflicts of interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Esther K, Suchika G, Marlon A, Julian G, Alastair GS. Jude Local anaesthesia of the pharynx for OesophaoGastroDuodenoscopy (OGD); new technique with better patient tolerance and reduced risk of airborne spread.A.

Publikationsverlauf

Artikel online veröffentlicht:
15. April 2024