Is topical lidocaine beneficial before catheter insertion in esophageal manometry and ambulatory pH monitoring?
Administration, Topical
Adult
Aged
Anesthetics, Local
/ therapeutic use
Case-Control Studies
Esophageal Motility Disorders
/ diagnosis
Esophageal pH Monitoring
/ methods
Esophagus
Female
Humans
Lidocaine
/ therapeutic use
Male
Manometry
/ methods
Middle Aged
Pain, Procedural
/ prevention & control
Patient Satisfaction
Prospective Studies
esophageal manometry
lidocaine
pH monitoring
topical anesthesia
Journal
Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
06
05
2019
revised:
06
06
2019
accepted:
09
07
2019
pubmed:
20
7
2019
medline:
26
8
2020
entrez:
20
7
2019
Statut:
ppublish
Résumé
Conventionally, topical anesthesia is applied to improve the tolerance of esophageal manometry (EM) and ambulatory pH monitoring (apH) but there is presently no evidence supporting this practice. We aimed to compare the tolerance of EM and apH with vs without topical lidocaine anesthesia. A prospective study was conducted at our center between January 2017 and January 2019. All patients who underwent EM or apH and completed a systematically distributed standardized patient survey were included. From January 2017 to June 2018, all patients had a viscous lidocaine solution applied before EM and apH ("lidocaine" group). After June 2018, we ceased applying any topical anesthesia ("no lidocaine" group). Patient-reported adverse effects and satisfaction scores were compared between these two patient groups. Two hundred forty-nine patient surveys were included. "Lidocaine" (n = 124) and "no lidocaine" (n = 125) groups were similar in age (56.9 ± 14.0 vs 56.0 ± 13.7; P = .77) and gender distributions (65.9% vs 63.3% female; P = .68). Patients in the "lidocaine" group were less likely to report pain during catheter insertion (33.6% vs 50.8%; P = .007, OR: 0.49 [95% CI 0.29-0.83]) and reported a lower overall pain score (2.82 ± 1.38 vs 3.20 ± 1.42 on 5; P = .04). There was a tendency toward increased global satisfaction with lidocaine application but that was not statistically significant (4.36 ± 1.05 vs 4.11 ± 1.13; P = .08). In subgroup analyses, female patients, younger patients, and patients who underwent EM were more likely to benefit from lidocaine application. Application of topical lidocaine before esophageal motility tests reduces pain during catheter insertion and overall pain.
Sections du résumé
BACKGROUND
Conventionally, topical anesthesia is applied to improve the tolerance of esophageal manometry (EM) and ambulatory pH monitoring (apH) but there is presently no evidence supporting this practice. We aimed to compare the tolerance of EM and apH with vs without topical lidocaine anesthesia.
METHODS
A prospective study was conducted at our center between January 2017 and January 2019. All patients who underwent EM or apH and completed a systematically distributed standardized patient survey were included. From January 2017 to June 2018, all patients had a viscous lidocaine solution applied before EM and apH ("lidocaine" group). After June 2018, we ceased applying any topical anesthesia ("no lidocaine" group). Patient-reported adverse effects and satisfaction scores were compared between these two patient groups.
KEY RESULTS
Two hundred forty-nine patient surveys were included. "Lidocaine" (n = 124) and "no lidocaine" (n = 125) groups were similar in age (56.9 ± 14.0 vs 56.0 ± 13.7; P = .77) and gender distributions (65.9% vs 63.3% female; P = .68). Patients in the "lidocaine" group were less likely to report pain during catheter insertion (33.6% vs 50.8%; P = .007, OR: 0.49 [95% CI 0.29-0.83]) and reported a lower overall pain score (2.82 ± 1.38 vs 3.20 ± 1.42 on 5; P = .04). There was a tendency toward increased global satisfaction with lidocaine application but that was not statistically significant (4.36 ± 1.05 vs 4.11 ± 1.13; P = .08). In subgroup analyses, female patients, younger patients, and patients who underwent EM were more likely to benefit from lidocaine application.
CONCLUSIONS AND INFERENCES
Application of topical lidocaine before esophageal motility tests reduces pain during catheter insertion and overall pain.
Substances chimiques
Anesthetics, Local
0
Lidocaine
98PI200987
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13687Informations de copyright
© 2019 John Wiley & Sons Ltd.
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