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New lidocaine lozenge as topical anesthesia compared to lidocaine viscous oral solution before upper gastrointestinal endoscopy

Authors Mogensen S, Treldal C, Feldager E, Pulis S, Jacobsen J, Andersen O, Rasmussen M

Received 10 February 2012

Accepted for publication 18 March 2012

Published 31 May 2012 Volume 2012:5 Pages 17—22


Review by Single anonymous peer review

Peer reviewer comments 3

Stine Mogensen,1 Charlotte Treldal,1 Erik Feldager,2 Sylvia Pulis,1 Jette Jacobsen,3 Ove Andersen,1 Mette Rasmussen,4
1Clinical Research Centre, Hvidovre University Hospital, Copenhagen, Denmark; 2Department of Gastroenterology, Hvidovre University Hospital, Copenhagen, Denmark; 3Department of Pharmaceutics and Analytical Chemistry, Faculty of Pharmaceutical Sciences, University of Copenhagen, Denmark; 4Department of Pharmacology and Pharmacotherapy, Faculty of Pharmaceutical Sciences, University of Copenhagen, Denmark

Objective: To evaluate the effect and acceptance of a new lidocaine lozenge compared with a lidocaine viscous oral solution as a pharyngeal anesthetic before upper gastrointestinal endoscopy (UGE), a diagnostic procedure commonly performed worldwide during which many patients experience severe discomfort mostly because of the gag reflex.
Participants: The single-blinded, randomized, controlled study involved 110 adult patients undergoing diagnostic UGE at the Department of Gastroenterology, Hvidovre University Hospital, Denmark.
Methods: The patients were randomized to receive either 100 mg lidocaine as a lozenge or 5 mL lidocaine viscous oral solution 2%. Intravenous midazolam was administered if needed. The effect of a lidocaine lozenge in reducing patient discomfort, including the gag reflex, during UGE compared with a lidocaine oral solution was assessed.
Results: Questionnaires from the patients showed that the gag reflex was acceptable for 64% in the lozenge group compared with 33% in the oral solution group (P = 0.0072). UGE was evaluated as acceptable by 69% in the lozenge group compared with 39% in the oral solution group (P = 0.0092). The taste was evaluated as good by 78% in the lozenge group (P < 0.0001), and 82% found the lozenge to have good texture (P < 0.0001).
Conclusion: The lozenge reduced the gag reflex, diminished patients’ discomfort during UGE, and was evaluated as having a good taste and texture. The lozenge improved patients’ acceptance of UGE.

Keywords: upper gastrointestinal endoscopy, topical pharyngeal anesthetic, lidocaine lozenge

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