Topical lidocaine against deep sedation for intragastric balloon insertion

Background Intragastric balloon (IGB) insertion is a known method for the treatment of the special group of morbidly obese patients. The procedure can be performed under general anesthesia or deep sedation; however, it is associated with many complications, particularly respiratory complications, in this risky group of patients, which makes topical anesthesia an acceptable alternative option. Aim The aim of this study was to demonstrate the efficacy of topical anesthesia for IGB insertion in comparison with the deep-sedation technique. Patients and methods A total of 100 patients were enrolled in the study, and were divided into two groups. The T group received topical anesthesia in the form of lidocaine gel ± lidocaine spray. If the patient did not tolerate the endoscope advancement, either midazolam or alfentanil was given, whereas S group patients received deep sedation in the form of alfentanil, propofol, and midazolam. Results Endoscopy was performed in all patients successfully. The topical group had more hemodynamic stability, less respiratory adverse events, a shorter time to return to baseline condition, and higher patient satisfaction compared with the other group. Conclusion The use of topical anesthesia is an effective technique for IGB insertion as it provides a good operative condition and a safer procedure for high-risk morbidly obese patients, with high patient satisfaction.