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Gastrointest Interv. 2016 Mar;5(1):67-71. English. Original Article.
Cha BH , Lee BS , Hwang JH , Lee SH , Park MJ , Kang SJ .
Department of Gastroenterology, Division of Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates.
Digestive Disease Center, Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea.
Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Kyungpook National University College of Medicine, Daegu, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

BACKGROUND: Topical pharyngeal anesthesia reduces discomfort during upper gastrointestinal endoscopy (UGIE) but may not increase tolerance to the procedure. This case-control study was performed to assess whether lidocaine spray on the endoscope in addition to pharyngeal anesthesia improves patient tolerance to endoscopy we performed. METHODS: Patients who underwent UGIE were assigned to either the case group where the endoscope was treated with 2 sprays of 10% lidocaine before insertion or the control group given only conventional pharyngeal anesthesia. And we compared the frequency of belching and retching during endoscopy. RESULTS: Among 497 eligible patients, 262 were assigned to the case group and 235 to the control group. There were significant differences between the two groups in belching (odds ratio [OR] = 0.15, 95% confidence interval [CI] = 0.09-0.24, P < 0.01) and retching (OR = 0.22, 95% CI = 0.15-0.34, P = 0.01) during endoscopy using multivariate analysis. Younger patients (OR = 0.96, 95% CI = 0.94-0.98, P < 0.01) and female patients (OR = 2.16, 95% CI = 1.40-3.33, P = 0.01) had belching more frequently than older patients and male patients, respectively. Retching was more frequent in sedated patients (OR = 0.39, 95% CI = 0.25-0.61, P = 0.01) and those with gastro-esophageal reflux disease (OR = 1.48, 95% CI = 1.00-2.21, P = 0.06). CONCLUSIONS: Use of lidocaine spray on the endoscope improves patient tolerance during UGIE compared to only conventional pharyngeal anesthesia.

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