Double Blinded Randomised Controlled Trial Comparing Lidocaine Viscous and Lidocaine Lozenges Prior to Upper Gastrointestinal Endoscopy

Background: Upper gastrointestinal endoscopy is a commonly performed procedure now days for various indications. Usually it can be done as an outpatient procedure without anaesthesia and sedation. Local pharyngeal anaesthesia is used in the form of gel, viscous and spray. Recently there is introduction of lidocaine lozenges for this purpose with many benefits.

Objective: Purpose of this study was to compare the safety, efficacy and patient comfort for the lidocaine viscous and lidocaine lozenges as a single agent local pharyngeal anaesthesia before upper gastrointestinal endoscopy.

Design: Double blinded randomised prospective study.

Patients: 100 consecutive patients undergoing upper gastrointestinal endoscopy.

Methods and Interventions: Randomisation of patients was done into lidocaine viscous group and lidocaine lozenges group before the procedure and the endoscopist and patients were interviewed separately after the procedure. Anxiety, Gag reflex, difficulty of procedure and tolerability of the procedure were graded by the patients and endoscopist.

Results: Patients in the lozenges group exhibited less discomfort, tolerated the procedure better than that in the viscous group. The endoscopist experienced lesser difficulty in performing the procedure. None of the 100 patients needed any form of anaesthesia and all completed the procedure.

Conclusions: Lidocaine lozenge is a better alternative for local pharyngeal anaesthesia before upper gastrointestinal endoscopy. It resulted in lesser discomfort and increased tolerability of the procedure, for the patient and lesser difficulty in performing the procedure, for the endoscopist.