Atomized lidocaine as topical anesthesia for nasogastric tube placement: A randomized, double-blind, placebo-controlled trial.
OBJECTIVE
To evaluate the efficacy of topical atomized 4% lidocaine in reducing the pain associated with nasogastric tube (NGT) placement.


METHODS
This prospective, randomized, double-blind, placebo-controlled trial was conducted in the emergency department of a university teaching hospital. Study participants were alert, hemodynamically stable adult patients requiring NGT placement for diagnostic or therapeutic purposes. Atomized 4% lidocaine or normal saline solution was administered in the nasopharynx and oropharynx before NGT placement. All patients also received topical 2% lidocaine jelly intranasally after atomization. The pain of NGT placement was measured using a standard 100-mm visual analog scale.


RESULTS
A total of 40 patients were enrolled in the study, with 20 in the lidocaine group and 20 in the placebo group. Mean pain scores were 37.4 mm (95% confidence interval [CI] 25.4 to 49.4) for atomized lidocaine and 64.5 mm (95% CI 51.8 to 77.1) for placebo with a mean difference of 27.1 mm (95% CI 14.8 to 39.4), achieving both clinical and statistical significance.


CONCLUSIONS
Atomized nasopharyngeal and oropharyngeal 4% lidocaine results in clinically and statistically significant reductions in pain during NGT placement.
Wolfe
T R
TR
Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
Fosnocht
D E
DE
Linscott
M S
MS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D002648:Child; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010147:Pain Measurement; D011446:Prospective Studies
D008012:Lidocaine