Topical viscous lidocaine solution versus lidocaine spray for pharyngeal anesthesia in unsedated esophagogastroduodenoscopy

S. Amornyotin, W. Srikureja, W. Chalayonnavin, S. Kongphlay, S. Chatchawankitkul
  • Endoscopy, July 2009, Thieme Publishing Group
  • DOI: 10.1055/s-0029-1214865

Topical viscous lidocaine solution versus lidocaine spray in unsedated esophagogastroduodenoscopy

What is it about?

Pharyngeal anesthesia using topical lidocaine is generally used as pretreatment for unsedated esophagogastroduodenoscopy (UEGD). The aim of this study was to compare and evaluate the clinical efficacy of topical viscous lidocaine solution and lidocaine spray when each is used as a single agent for UEGD.

Why is it important?

The procedure was successfully completed in 868 patients from group V (93.3%) and 931 patients from group S (99.7%; P < 0.001). Patients and endoscopists reported a higher degree of satisfaction in group S than group V (P < 0.0001). Procedural pain score in group Swas significantly lower than in group V (P < 0.0001). The endoscopist rated patients in group S as having better tolerance and ease of intubation than those in group V (P = 0.0004 and P = 0.002, respectively). Adverse events occurred in 370 patients in group V and 316 patients in group S (P = 0.002). These were mainly transient changes in vital signs including hypertension, tachycardia, and bradycardia.


Somchai Amornyotin
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University

The use of lidocaine spray in UEGD was shown to result in a higher procedural completion rate, greater ease of intubation, and greater patient and endoscopist satisfaction. Topical lidocaine spray may be a better form of pharyngeal anesthesia than viscous lidocaine solution in UEGD.

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The following have contributed to this page: Somchai Amornyotin