Abstract
Propofol sedation has been applied during esophagogastroduodenoscopy procedures, but whether topical pharyngeal anesthesia should be administered at the same time has rarely been reported. Our study examined the role of topical pharyngeal anesthesia in sedated endoscopies in a randomized controlled double-blinded clinical trial. A total of 626 patients who underwent sedated esophagogastroduodenoscopy were randomized into the experimental group (n = 313) or the control group (n = 313). The discomfort score, immediately and one day after the procedure, was not statistically significant [7.2 (5–9) vs. 7.5 (6–9), P = 0.210; 2.3 (0–3) vs. 2.6 (0–4), P = 0.095, respectively]. Two patients in the experimental group and three patients in the control group needed oral medication for pharyngeal discomfort (P = 0.354). The satisfaction score was 9.2 (8–10) in the experimental group and 8.9 (7–10) in the control group (P = 0.778). Lidocaine topical pharyngeal anesthesia in propofol-sedated esophagogastroduodenoscopy did not further reduce the pharyngeal discomfort or improve the satisfaction. This clinical trial was registered at ClinicalTrials.gov (ClinicalTrials.gov ID: NCT03070379).
Highlights
Esophagogastroduodenoscopy is a very important tool for diagnosing and treating upper gastrointestinal diseases[1]
Whether lidocaine topical pharyngeal anesthesia should be administered is still in doubt[6], lidocaine topical pharyngeal anesthesia as a routine pretreatment for esophagogastroduodenoscopy may facilitate the intubation of the endoscopy and reduce the injury of the pharyngeal mucosa[7]
Considering the fact that lidocaine anesthesia may cause airway narrowing and anaphylaxis, it is important to examine the role of lidocaine topical pharyngeal anesthesia in esophagogastroduodenoscopy under propofol sedation, which has rarely been reported in large-scale clinical trials so far; the findings have not quite been consistent among different studies[10,12]
Summary
Esophagogastroduodenoscopy is a very important tool for diagnosing and treating upper gastrointestinal diseases[1]. Propofol sedation has been widely introduced in sedated endoscopic examinations, which has the advantages of less adverse events, high satisfaction, less discomfort and simple administration[3,4,5]. For those sedated patients, whether lidocaine topical pharyngeal anesthesia should be administered is still in doubt[6], lidocaine topical pharyngeal anesthesia as a routine pretreatment for esophagogastroduodenoscopy may facilitate the intubation of the endoscopy and reduce the injury of the pharyngeal mucosa[7]. At investigating whether lidocaine topical pharyngeal anesthesia could benefit patients who underwent esophagogastroduodenoscopy under propofol sedation
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