A Randomized, Double-Blind, Placebo-Controlled Study to Evaluate Topical Anaesthesia of the Pharynx in Upper Gastrointestinal Endoscopy

Abstract Reduction of discomfort during diagnostic upper endoscopy may not be desired by patients if the medication has long-lasting and severe after-effects. The present study was designed to examine whether topical anaesthesia of the pharynx without concomitant sedation is of overall benefit to patients undergoing diagnostic upper endoscopy. Two hundred out-patients were randomized to receive in the form of a pharyngeal spray either 80-120 mg lidocaine or placebo. Patients assessed discomfort on a 100 mm visual analogue scale the day after examination. Patients undergoing endoscopy who received lidocaine spray experienced significantly less discomfort from the intubation (p = 0.0001), and discomfort induced by the rest of the examination was also reduced (p = 0.003). The outcome of the endoscopists' assessment was also in favour of lidocaine spray for intubation (p = 0.157) and ease of examination (p = 0.0014). The assessment of throat discomfort suffered by patients after endoscopy did not differ between the groups. A majority of patients, the same proportion in each group, stated they would prefer their next endoscopy to be performed with topical anaesthesia.