title: Effect of Lidocaine on Swallowing During FEES in Patients With Dysphagia.
abstract: OBJECTIVE
  The aims of this study were to assess the effects of 0.2 mL of 4% atomized lidocaine on swallowing and tolerability during Fiberoptic Endoscopic Evaluation of Swallowing (FEES).
  
  
  METHODS
  A single blinded study was conducted with 17 dysphagic patients, who received 4 standardized boluses in 2 sequential FEES exams under 2 conditions: non-anesthetized (decongestant only) and anesthetized (lidocaine 4%+decongestant). After each procedure, patients rated their pain on the Wong Baker FACES Pain Rating Scale. Clinicians scored each swallow with the Penetration Aspiration Scale (PAS) and an author-developed Residue Rating Scale. Because the assessments were ordinal, a series of Wilcoxon signed-rank tests were conducted to detect differences between the 2 conditions.
  
  
  RESULTS
  No significant differences were detected between groups on PAS or residue in the 4 boluses. Pain scores, however, were significantly lower in the anesthetized condition than the decongested-only condition (P=.035).
  
  
  CONCLUSIONS
  The findings of this study indicated that 0.2 mL of 4% lidocaine enhanced exam tolerability and did not impair the swallow in dysphagic patients.
authors: MGH Institute of Health Professions, Charlestown Navy Yard, Boston, Massachusetts, USA Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts, USA modea1@mghihp.edu.
authors: Meredith B
authors: MB
authors: O'Dea
authors: Department of Otolaryngology, Boston University School of Medicine, Boston, Massachusetts, USA Department of Speech Language Hearing Sciences, Boston University, Sargent College, Boston, Massachusetts, USA.
authors: Susan E
authors: SE
authors: Langmore
authors: Department of Otolaryngology, Boston University School of Medicine, Boston, Massachusetts, USA.
authors: Gintas P
authors: GP
authors: Krisciunas
authors: Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts, USA.
authors: Michael
authors: M
authors: Walsh
authors: Department of Speech Language Hearing Sciences, Boston University, Sargent College, Boston, Massachusetts, USA.
authors: Linsey L
authors: LL
authors: Zanchetti
authors: Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts, USA.
authors: Rebecca
authors: R
authors: Scheel
authors: Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts, USA.
authors: Edel
authors: E
authors: McNally
authors: Department of Speech Language Hearing Sciences, Boston University, Sargent College, Boston, Massachusetts, USA.
authors: Asako Satoh
authors: AS
authors: Kaneoka
authors: MGH Institute of Health Professions, Center for Interprofessional Studies and Innovation, Boston, Massachusetts, USA.
authors: Anthony J
authors: AJ
authors: Guarino
authors: Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
authors: Susan G
authors: SG
authors: Butler
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D003679:Deglutition / Q000187:drug effects* / Q000502:physiology; D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology*; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005336:Fiber Optic Technology / Q000295:instrumentation*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D017060:Patient Satisfaction; D016037:Single-Blind Method
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: FEES; aspiration; patient comfort; penetration; topical anesthetic