DR SHANTHI S,DR BHARATHI B B,DR KISHANTH
DOI: https://doi.org/Background: Gag reflex and discomfort during upper gastrointestinal endoscopy (EGD) can affect patient tolerance and procedural success. Lidocaine spray, while commonly used, often provides suboptimal anesthesia and is poorly tolerated. Lidocaine lollipop, a novel delivery system, may offer better mucosal anesthesia and improve patient comfort.
Objective: To compare the efficacy of lidocaine lollipop versus lidocaine spray as sole topical anesthetic agents in reducing gag reflex, sedation needs, and procedure difficulty, while enhancing patient satisfaction during diagnostic EGD.
Methods: Fifty adult patients were randomized into two groups: LL Group (200 mg lidocaine lollipop, n=25) and LS Group (200 mg lidocaine spray, n=25). Primary outcomes included gag reflex severity and patient satisfaction. Secondary outcomes included sedation requirement, procedure difficulty, patient cooperation, and procedure duration. Data were analyzed using ANOVA, Chi-square, and Pearson correlation.
Results: Patients in the LL Group demonstrated significantly reduced gag reflex scores (mean 1.8 ± 0.6 vs. 3.2 ± 0.9, p<0.001), lower sedation requirements (20% vs. 64%, p=0.002), and shorter procedure durations (5.9 ± 1.2 min vs. 7.6 ± 1.5 min, p=0.001). Patient satisfaction was higher in the LL Group (VAS score 9.2 ± 0.5 vs. 7.3 ± 1.1, p<0.001), and willingness to use the same method again was reported by 96% in LL vs. 68% in LS group.
Conclusion: Lidocaine lollipop is a superior alternative to spray in providing effective topical anesthesia for EGD. It significantly reduces gag reflex, decreases sedation requirements, shortens procedure time, and improves patient satisfaction.
