Palatal lidocaine gel as an adjuvant to propofol versus propofol only for sedation during upper gastrointestinal tract endoscopy: a comparative study

Background Lidocaine gel is a palatable preparation of lidocaine 2% that is produced by Amoun Pharmaceutical Co. (Cairo, Egypt). Aim The aim of the study was to evaluate the efficacy of palatable lidocaine gel as an adjuvant to propofol for anesthesia during upper gastrointestinal tract endoscopy in terms of propofol consumption, ease of performance of the procedure, and recovery time. Patients and methods A prospective randomized clinical study was conducted on 100 patients undergoing diagnostic esophagogastroduodenoscopy in Ain Shams University hospitals, who were randomized into two groups of 50 patients each. In the first group (X group), 15 mg of palatable lidocaine gel together with intravenous sedation using propofol was used, whereas in the control group (C group) intravenous sedation with propofol only was given. Measurements in both groups included propofol consumption as well as the incidence of apnea and hypoxia, recovery time, and both endoscopist and patient satisfaction. Results Patients in the palatable lidocaine gel group (X group) tolerated the procedure better than those in the control group (C group). The endoscopists encountered less difficulty performing the procedure in the X group. In addition, propofol consumption and the incidence of apnea and hypoxia were lower in the X group, and recovery time was significantly shorter in the X group. The patients in the X group were more satisfied with the mode of anesthesia they received as compared with patients in the C group. The endoscopists were equally satisfied with the mode of anesthesia in both groups. Conclusion The use of palatable lidocaine gel in esophagogastroduodenoscopy decreases propofol consumption, shortens recovery time, and improves patient comfort and tolerance to the procedure, and also reduces the cost.