2. Topical Anesthetics: Are They Worth The Effort?
Prospective, randomized controlled trials addressing the use of
topical anesthetics during upper endoscopy for improved patient
tolerance have been mixed .
Existing study designs differ in the presence of double-blinding, the
type of topical anesthetic employed, endoscope diameter, and the use
of conscious sedation. Soma et al.
Recently conducted a study of 201 Japanese patients who were
randomized to receive either 2% lidocaine or placebo.
No conscious sedation was employed.
Multivariate analysis found that the use of topical anesthesia
reduced the relative risk of discomfort by 44% (95% CI: 0.31–
1.01).
Patient age less than 40 was associated with a higher relative risk
of discomfort (RR 2.22, 95% CI: 1.04–4.74).
Subgroup analysis found that patients less than 40 years of age
who were pretreated or those undergoing endoscopy for
the first time benefited most from topical anesthesia.
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