The questionable efficacy of topical pharyngeal anesthesia in combination with propofol sedation in gastroscopy.

Digestive Diseases and Sciences
Hsin-I TsaiHuang-Ping Yu

Abstract

Topical pharyngeal anesthesia as an adjunct to intravenous sedation to facilitate gastroscopy has been widely acknowledged; however, its efficacy has not been established when it is used in patients under deep sedation with propofol. To demonstrate the limited value of topical pharyngeal anesthesia in patients under moderate to deep sedation with propofol. One hundred and twenty-nine patients undergoing gastroscopy were prospectively randomized to receive 10 % lidocaine or distilled water topical spray as an adjunct to intravenous propofol via target-controlled infusion. Verbal and somatic responsiveness, presence of gag reflex and hiccup to esophageal intubation, and the overall ease of the procedure were evaluated by the anaesthetists and gastroenterologists. Hemodynamic parameters including peripheral oxygen saturation, systolic/diastolic blood pressure (SBP/DBP), heart rate (HR), bispectral index, and SBP × HR were compared at 5 time points: on arrival, after 5 spontaneous breaths, when estimated brain concentration of propofol, Ce, reached 3.5 μg/ml, on esophageal intubation, and on awakening. No statistical difference was observed between the lidocaine and distilled water group in verbal or somatic responses, gag reflex o...Continue Reading

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Citations

Sep 17, 2013·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Yen-Hsuan HsuWei-Zen Sun
Oct 14, 2021·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Irene Martín-MarcosEstíbaliz Cristóbal-Domínguez

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