Relation of viscous lidocaine combined with propofol deep sedation during elective upper gastrointestinal endoscopy to discharge

• Published in: Proceedings - Baylor University. Medical Center 2019-10, Vol.32 (4), p.505-509
• Main Authors: Ullman, David A., Saleem, Sheikh A., Shahnawaz, Afeefa, Kotakanda, Shashank, Scribani, Melissa B., Victory, Jennifer M.
• Format: Article
• Language: English
• Subjects: Lidocaine; Medical treatment; Original Research; Patient satisfaction; pharyngeal anesthetics; Placebo effect; propofol; sedation; Studies; upper gastrointestinal endoscopy; viscous xylocaine
• ISSN: 0899-8280; 1525-3252
• DOI: 10.1080/08998280.2019.1641058

Fusing topical pharyngeal anesthetics (TPAs) to intravenous sedation during esophagogastroduodenoscopy (EGD) has been controversial. This double-blind, randomized, placebo-controlled trial assessed the association of TPA with patient recovery time, post-EGD to discharge. Supplementary aims were to determine the association of TPA with patient and practitioner satisfaction (both measured on a 100-mm visual analog scale), total propofol dose, and side effects. The study included 93 patients (mean age 53.8 years, range 44-67; 37 men and 56 women) undergoing elective EGD at a single academic medical center from September 2015 to October 2016. Urgent or therapeutic EGDs were excluded. Interventions were 7.5 mL 2% lidocaine viscous solution and 7.5 mL placebo solution (3% methylcellulose). There were no statistically significant differences between the lidocaine (n = 46) and placebo (n = 47) groups with respect to recovery time (42 ± 17.8 vs 39 ± 15.9 minutes; P = 0.23), procedure time (6.5 ± 2.7 vs 7 ± 3.6 minutes; P = 0.77), endoscopist satisfaction (83.2 ± 24.4 vs 77 ± 27.7, P = 0.23), patient discomfort (16.6 ± 19.8 vs 24.0 ± 29.7, P = 0.37), or total propofol administered (2.3 ± 1.3 vs 2.3 ± 1.0 mg/kg, P = 0.55). Compared to placebo, topical viscous lidocaine does not appear to delay recovery time or adversely affect sedation-related outcomes.