TOPICAL PHARYNGEAL ANESTHESIA IMPROVES TOLERANCE OF UPPER GASTROINTESTINAL ENDOSCOPY - A RANDOMIZED DOUBLE-BLIND-STUDY

Background and Study Aims: The usefulness of topical pharyngeal anesth esia is not well established, The aim of the present study was to dete rmine its benefits in relation to patient tolerance and facilitation o f the procedure in unsedated patients undergoing upper gastrointestina l endoscopy. Patients and Methods: A randomized double-blind study com paring Topicaina spray - a mixture of benzocaine butyl aminobenzoate ( butoforme), amethocaine, and butacaine - and a placebo was carried out on 256 outpatients referred for diagnostic endoscopy, No additional p remedication was used, After the examination, both the tolerance to an d difficulty of the intubation and examination were evaluated by patie nts and endoscopists respectively, using visual analogue scales and a questionnaire. Results: Three patients (1.2 %) did not tolerate the en doscopy, One patient was excluded for unexpected therapeutic endoscopy , One hundred twenty-five patients received the active spray and 127 r eceived the placebo, The two groups were similar with respect to patie nt characteristics, Both intubation and examination, assessed with vis ual analogue scales, were better tolerated (both p=0.0001) and more ea sily performed (p=0.02 and p=0.0001 respectively) in the active treatm ent group, Patients receiving the active spray had a better tolerance for the procedure, according to questionnaire replies. Conclusions: To pical pharyngeal anesthesia in unsedated patients undergoing diagnosti c upper gastrointestinal endoscopy improves tolerance and makes examin ation easier.