The effect of topical pharyngeal anesthesia with Flurbiprofen plus Lidocaine spray vs Lidocaine spray before unsedated upper gastrointestinal endoscopy

Aims Esophagogastroduodenoscopy (EGD) under topical pharyngeal anesthesia has the advantage of avoiding the adverse events and post-procedural impairment following the sedated procedure. The aim of this study was to assess whether topical pharyngeal anesthesia with both Flurbiprofen and Lidocaine spray improves patient tolerance and endoscopist satisfaction compared to Lidocaine spray alone.

Methods We designed a monocentric, double blind, randomized trial designed to compare unsedated EGD with topical Flurbiprofen spray (Strepsils Intensive) plus Lidocaine spray versus Lidocaine spray alone. Patients’ tolerance and endoscopist satisfaction were quantified post procedure using a 0 to 10 points visual numerical rating scale.

Results 36 patients were included and randomized in 2 equal groups – Lidocaine and Flurbiprofen spray group (LP) and Lidocaine spray group (L). There were no significant differences among groups for patient discomfort score (LP 5.33±2.42, L 5.56±2.12, p=0.708), pain score (LP 1.77±2.17, L 1.89±0.74, p=0.119), gag reflex intensity score (LP 1.61±0.82, L 1.83±0.68, p=0.418), patient satisfaction score (LP 7.78±2.46, L 7.22±1.78, p=0.428), and endoscopist satisfaction score (LP 7.5±2.87, L 7.58±1.45, p=0.312).

Conclusions Both the Lidocaine plus Strepsils spray and Lidocaine spray alone were safe and well tolerated. Patients level of discomfort, pain, gag reflex and satisfaction and endoscopist satisfaction were not significantly improved by adding Flurbiprofen spray to Lidocaine spray sedation.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025