Posterior lingual lidocaine: a novel method to improve tolerance in upper gastrointestinal endoscopy.

Journal Article (Journal Article)

AIM: To evaluate the effect of posterior lingual lidocaine swab on patient tolerance to esophagogastroduodenoscopy, the ease of performance of the procedure, and to determine if such use will reduce the need for intravenous sedation. METHODS: Eighty patients undergoing diagnostic esophagogastroduodenoscopy in a tertiary care medical center were randomized to either lidocaine swab or spray. Intravenous meperidine and midazolam were given as needed during the procedure. RESULTS: Patients in the lidocaine swab group (SWG) tolerated the procedure better than those in the spray group (SPG) with a median tolerability score of 2 (1, 4) compared to 4 (2, 5) (P < 0.01). The endoscopists encountered less difficulty performing the procedures in the SWG with lower median difficulty scores of 1 (1, 5) compared to 4 (1, 5) in the SPG (P < 0.01). In addition, the need for intravenous sedation was also lower in the SWG compared to the SPG with fewer patients requiring intravenous sedation (13/40 patients vs 38/40 patients, respectively, P < 0.01). The patients in the SWG were more satisfied with the mode of local anesthesia they received as compared to the SPG. In addition, the endoscopists were happier with the use of lidocaine swab. CONCLUSION: The use of a posterior lingual lidocaine swab in esophagogastroduodenoscopy improves patient comfort and tolerance and endoscopist satisfaction and decreases the need for intravenous sedation.

Full Text

Duke Authors

Cited Authors

  • Soweid, AM; Yaghi, SR; Jamali, FR; Kobeissy, AA; Mallat, ME; Hussein, R; Ayoub, CM

Published Date

  • December 21, 2011

Published In

Volume / Issue

  • 17 / 47

Start / End Page

  • 5191 - 5196

PubMed ID

  • 22215944

Pubmed Central ID

  • PMC3243886

Electronic International Standard Serial Number (EISSN)

  • 2219-2840

Digital Object Identifier (DOI)

  • 10.3748/wjg.v17.i47.5191


  • eng

Conference Location

  • United States