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.
