A randomized controlled trial to compare the efficacy of xylocaine spray and amethocaine lozenge in preparing patients for oesophago‐gastro‐ duodenoscopy (OGD)

Abstract

Xylocaine spray and amethocaine lozenge are used as local anaesthetic to prepare patients for OGD. Xylocaine is more widely used while the cost of amethocaine is half that of xylocaine for the use per patient. We conducted a prospective randomized controlled trial to compare their efficacy in terms of patient discomfort (patient satisfaction score) and the ease of the procedure (endoscopist score). A total of 127 patients undergoing elective OGD were recruited (from 1/9/03 to 5/1/04). They were randomly assigned by the use of random number to use either xylocaine or amethocaine as the local anaesthetic agent. There were 55 males and 75 females. 70 patients were randomized to the ‘xylocaine’ group while 57 patients were randomized to the ‘amethocaine’ group. There was no significant difference between the demographic data of the two groups. OGD was performed by a single endoscopist, who was blinded to the type of local anaesthetic used. After OGD, an independent endoscopy nurse asked the patient for the satisfaction score. There was no statistically significant difference between the two groups in terms of satisfaction scores and the ease of procedure. Both drugs were well tolerated. No complication related to drug or procedure occurred. We conclude that xylocaine and amethocaine are equally effective in preparing patients for OGD. The cost of amethocaine lozenge is lower.