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http://dx.doi.org/10.5223/pghn.2017.20.2.87

Investigation of Efficacy of Lidocaine Spray for Sedated Esophagogastroduodenoscopy in Children  

Basturk, Ahmet (Department of Pediatric Gastroenterology, Faculty of Medicine, Akdeniz University)
Artan, Reha (Department of Pediatric Gastroenterology, Faculty of Medicine, Akdeniz University)
Yilmaz, Aygen (Department of Pediatric Gastroenterology, Faculty of Medicine, Akdeniz University)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.20, no.2, 2017 , pp. 87-93 More about this Journal
Abstract
Purpose: Our aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children. Methods: The endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion. Results: Sedation was not applied in 24.1% of the cases in topical lidocaine spray group (LS group) and in 5.7% of the cases in distilled water spray group (DS group). Gag reflex was observed in 6.5% of cases in LS group and 33.3% of cases in DS group (p=0.024), increased oral secretion was observed in 9.3% of cases in LS group and 51.7% of cases in DS group (p=0.038), sore throat was observed in 3.7% of cases in LS group and 35.6% of cases in DS group (p=0.019) and the difference was statistically significant. Conclusion: The study showed that topical pharyngeal lidocaine reduces both requirement and amount of IV sedation before EGD in children and sore throat, gag reflex and decreased oral secretion increase.
Keywords
Child; Esophagogastroduodenoscopy; Lidocaine spray; Sore throat; Gag reflex;
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1 Davis DE, Jones MP, Kubik CM. Topical pharyngeal anesthesia does not improve upper gastrointestinal endoscopy in conscious sedated patients. Am J Gastroenterol 1999;94:1853-6.   DOI
2 Hedenbro JL, Ekelund M, Jansson O, Lindblom A. A randomized, double-blind, placebo-controlled study to evaluate topical anaesthesia of the pharynx in upper gastrointestinal endoscopy. Endoscopy 1992;24:585-7.   DOI
3 Evans LT, Saberi S, Kim HM, Elta GH, Schoenfeld P. Pharyngeal anesthesia during sedated EGDs: is "the spray" beneficial? A meta-analysis and systematic review. Gastrointest Endosc 2006;63:761-6.   DOI
4 Gordon MJ, Mayes GR, Meyer GW. Topical lidocaine in preendoscopic medication. Gastroenterology 1976;71:564-9.
5 Lowrie L, Weiss AH, Lacombe C. The pediatric sedation unit: a mechanism for pediatric sedation. Pediatrics 1998;102:E30.   DOI
6 Martinez JL, Sutters KA, Waite S, Davis J, Medina E, Montano N, et al. A comparison of oral diazepam versus midazolam, administered with intravenous meperidine, as premedication to sedation for pediatric endoscopy. J Pediatr Gastroenterol Nutr 2002;35:51-8.   DOI
7 Green SM, Li J. Ketamine in adults: what emergency physicians need to know about patient selection and emergence reactions. Acad Emerg Med 2000;7:278-81.   DOI
8 Tolia V, Peters JM, Gilger MA. Sedation for pediatric endoscopic procedures. J Pediatr Gastroenterol Nutr 2000;30:477-85.   DOI
9 Quine MA, Bell GD, McCloy RF, Charlton JE, Devlin HB, Hopkins A. Prospective audit of upper gastrointestinal endoscopy in two regions of England: safety, staffing, and sedation methods. Gut 1995;36:462-7.   DOI
10 Soweid AM, Yaghi SR, Jamali FR, Kobeissy AA, Mallat ME, Hussein R, et al. Posterior lingual lidocaine: a novel method to improve tolerance in upper gastrointestinal endoscopy. World J Gastroenterol 2011;17:5191-6.   DOI
11 Ayoub C, Skoury A, Abdul-Baki H, Nasr V, Soweid A. Lidocaine lollipop as single-agent anesthesia in upper GI endoscopy. Gastrointest Endosc 2007;66:786-93.   DOI
12 Motamed F, Aminpour Y, Hashemian H, Soltani AE, Najafi M, Farahmand F. Midazolam-ketamine combination for moderate sedation in upper GI endoscopy. J Pediatr Gastroenterol Nutr 2012;54:422-6.   DOI
13 Salale N, Treldal C, Mogensen S, Rasmussen M, Petersen J, Andersen O, et al. Bupivacaine lozenge compared with lidocaine spray as topical pharyngeal anesthetic before unsedated upper gastrointestinal endoscopy: a randomized, controlled trial. Clin Med Insights Gastroenterol 2014;7:55-9.
14 Chan CK, Fok KL, Poon CM. Flavored anesthetic lozenge versus Xylocaine spray used as topical pharyngeal anesthesia for unsedated esophagogastroduodenoscopy: a randomized placebo-controlled trial. Surg Endosc 2010;24:897-901.   DOI
15 Ibis M, Arhan M, Ibis T, Onal IK, Erdal H, Utku OG. Lidocaine versus lidocaine plus benzydamine as a topical anesthesia regimen for unsedated upper gastrointestinal endoscopy: a comparison study. Turk J Gastroenterol 2015;26:224-7.   DOI
16 Brecelj J, Trop TK, Orel R. Ketamine with and without midazolam for gastrointestinal endoscopies in children. J Pediatr Gastroenterol Nutr 2012;54:748-52.   DOI
17 Langston WT, Wathen JE, Roback MG, Bajaj L. Effect of ondansetron on the incidence of vomiting associated with ketamine sedation in children: a double-blind, randomized, placebo-controlled trial. Ann Emerg Med 2008;52:30-4.   DOI
18 Green SM, Klooster M, Harris T, Lynch EL, Rothrock SG. Ketamine sedation for pediatric gastroenterology procedures. J Pediatr Gastroenterol Nutr 2001;32:26-33.   DOI
19 Wathen JE, Roback MG, Mackenzie T, Bothner JP. Does midazolam alter the clinical effects of intravenous ketamine sedation in children? A double-blind, randomized, controlled, emergency department trial. Ann Emerg Med 2000;36:579-88.   DOI
20 Clarke GA, Jacobson BC, Hammett RJ, Carr-Locke DL. The indications, utilization and safety of gastrointestinal endoscopy in an extremely elderly patient cohort. Endoscopy 2001;33:580-4.   DOI
21 Van Kouwen MC, Drenth JP, Verhoeven HM, Bos LP, Engels LG. Upper gastrointestinal endoscopy in patients aged 85 years or more. Results of a feasibility study in a district general hospital. Arch Gerontol Geriatr 2003;37:45-50.   DOI
22 al-Atrakchi HA. Upper gastrointestinal endoscopy without sedation: a prospective study of 2000 examinations. Gastrointest Endosc 1989;35:79-81.   DOI
23 Keeffe EB, O'Connor KW. 1989 A/S/G/E survey of endoscopic sedation and monitoring practices. Gastrointest Endosc 1990;36(3 Suppl):S13-8.