Comparative Study of Lidocaine Spray and Lidocaine Lozenges on Propofol Requirements during Upper GI Endoscopy

Introduction: Lidocaine spray is used before upper gastrointestinal endoscopy (UGE) routinely. A lozenge formulation with ease of administration, palatable taste and improved compliance could be preferred topical anesthesia. This study was conducted to evaluate the efficacy of lidocaine lozenges versus lidocaine spray on propofol requirement in diagnostic gastroduodenal endoscopy. Materials and Methods: Prospective study with two hundred patients undergoing diagnostic UGE were randomized either to lidocaine lozenge or spray groups. Ease of application, ease of procedure, level of gag reflex and investigators and patient’s global assessment were noted along with total dose of propofol administered. Comparison was done by using appropriate statistical test. Results: Significantly less dose of propofol (P < 0.0001) required along with less procedural difficulty and gag reflex during UGE with lidocaine lozenges compared to spray. Global assessment by patient and physician was favorable toward lozenges. Conclusions: Lidocaine lozenges significantly reduced propofol requirement with advantages of easy application, better suppression of gag reflex, better patient and endoscopist satisfaction compared with lidocaine spray.