Topical pharyngeal anesthesia without intravenous sedation during upper gastrointestinal endoscopy

Background: There have been conflicting reports about the usefulness of topical pharyngeal anesthesia as a pre-endoscopic medication. Aims: To assess the effect of topical pharyngeal anesthesia without intravenous sedatives on easing upper gastrointestinal endoscopy. Methods: 153 consecutive consenting patients were randomized to receive either placebo (normal saline) spray (78 patients) or 80 mg of 4% lidocaine spray (75 patients). Difficulty of intubation was judged both by the patient and the physician on a linear analogue scale. Results: There was no significant difference in the scores in the two groups (p > 0.05). The patient and physician assessments correlated well. Conclusions: Topical lignocaine spray does not facilitate upper gastrointestinal endoscopy in the absence of intravenous sedation.