Evaluation of topical pharyngeal anaesthesia by benzocaine lozenge for upper endoscopy.
BACKGROUND
Among the randomized controlled trials evaluating the effect of pharyngeal anaesthesia only some suggest benefit. Spray is irritating for some people and leaves bitter taste in the throat. We hypothesized that delivering the local anaesthetic as a sucking lozenge would benefit the patients in terms of decreasing anxiety and will improve procedure performance and patient tolerance.


OBJECTIVE
To determine whether benzocaine/tyrothricin sucking lozenges with conscious sedation is superior to conscious sedation alone, with respect to procedure performance and tolerance in patients undergoing upper endoscopy.


METHODS
One hundred and seventy-four adult patients undergoing upper endoscopy with conscious sedation completed the study. They were randomized to receive sucking lozenge containing benzocaine or placebo before the procedure. Patients were asked to rate prestudy anxiety, tolerance for topical pharyngeal anaesthesia, comfort during endoscopy, degree of difficulty of intubation, postprocedure throat discomfort and willingness to undergo subsequent examinations using a 10-cm visual analogue scale. Endoscopists were asked to estimate the ease of oesophageal intubation and procedure performance.


RESULTS
No significant statistical differences regarding all the points studied were found between the groups.


CONCLUSIONS
Topical pharyngeal anaesthesia with benzocaine/tyrothricin lozenges with conscious sedation has no advantages over conscious sedation alone in patients undergoing upper endoscopy.
Shaoul
R
R
Department of Pediatrics, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel. shaoul_r@012.net.il
Higaze
H
H
Lavy
A
A
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D001566:Benzocaine / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods*; D004338:Drug Combinations; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013607:Tablets; D014449:Tyrothricin / Q000008:administration & dosage
D000779:Anesthetics, Local; D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; D013607:Tablets; D014449:Tyrothricin; D001566:Benzocaine