AN OPEN LABEL COMPARATIVE STUDY BETWEEN XYLOCAINE LOZENGES AND XYLOCAINE SPRAY IN PATIENTS UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY IN A TERTIARY CARE CENTER

Aim -To determine the efficacy safety and ease of use of lidocaine lozenges for endoscopy as compared to Lidocaine spray.Methods- Total of 50 patients were taken and separated randomly in to Group A and Group B each containing 25 patients. Group A was given Lidocaine lozenge 200 mg to suck 15 minutes before and Group B was given Lidocaine Spray just prior to the upper GI endoscopy. Efficacy was assessed by Ease of the procedure,Gag refluxes in a 0 to 5 point scale. Physicians and Patients global assessment of topical analgesia were obtained. All the procedures were done by single experienced endoscopist. Comparison was made by SPSS version 17.Results- Lidocaine lozenge showed less difficulty in intubation (P 0.0001) and less gag reflux (P0.0001).Group A had 7 (29) patients with staining of mucosa with the lozenge which may pose difficulty in assessing the fine detail of the mucosa. In Group A 4 patients (16) said the analgesia was excellent 15 (62) said it was good and 5 (20) said the analgesia was fair. None said it was poor. In Group B 11 patients (42) said the analgesia was good, 13 (50) patients said the analgesia was fair and 1 (0.03) patient said it was poor.Conclusion- Lidocaine lozenge was more efficacious than lidocaine spray for topical analgesia before upper GI endoscopy .Lozenge stained the mucosa which may interfere with fine details of mucosa. This may be avoided by creating colorless lozenges in the future.