title: The effects of topical anesthetic on swallowing during nasoendoscopy.
abstract: OBJECTIVE
  To assess the effects of a typical otolaryngologic dose of 1 mL of 4% lidocaine on penetration aspiration scale scores and participant discomfort during flexible endoscopic evaluation of swallowing.
  
  
  METHODS
  A prospective pilot study.
  
  
  METHODS
  Twenty healthy participants consumed 12 swallows consisting of graduated volumes of milk, water, pudding, and cracker in anesthetized and nonanesthetized conditions. Each participant was randomly selected to begin with the anesthetized or nonanesthetized condition. Each participant returned within 7 days to repeat the study in the other condition. Digital recordings of their evaluations were scored via the penetration-aspiration scale in a blinded fashion. Participants recorded their discomfort and tolerance of each flexible endoscopic evaluation of swallowing.
  
  
  RESULTS
  The anesthetized condition yielded significantly worse swallowing function (P = .001) than the nonanesthetized condition. The nonanesthetized condition yielded greater discomfort and pain during the procedure (P = .006, .018), greater pain during insertion and removal of the endoscope (P = .002, .003) and less overall tolerance (P = .016) than the anesthetized condition.
  
  
  CONCLUSIONS
  A typical otolaryngologic anesthetic dose of 1 mL of 4% lidocaine during flexible endoscopic evaluation of swallowing predisposed healthy young adults to higher penetration aspiration scale scores (less safe swallowing) than the nonanesthetized condition; however, the anesthetic reduced discomfort and provided better overall tolerance. Future studies need to evaluate the effects of lower doses of lidocaine (0.2 and 0.5 mL) on swallowing function and comfort.
authors.affiliation: Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Lester
authors.forename: Susan E
authors.initials: SE
authors.lastname: Langmore
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Lintzenich
authors.forename: S Carter
authors.initials: SC
authors.lastname: Wright
authors.forename: Karen
authors.initials: K
authors.lastname: Grace-Martin
authors.forename: Tim
authors.initials: T
authors.lastname: Fife
authors.forename: Susan G
authors.initials: SG
authors.lastname: Butler
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003679:Deglutition / Q000187:drug effects*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine