[Comparison of two forms of nasal and pharyngeal topical anestesia for performing esophageal manometry].

BACKGROUND

The esophageal manometry (EM) is an invasive procedure that causes nasal pain, pharyngeal pain, and nausea. A topical anesthetic may improve tolerance of the examination.

OBJECTIVE

To compare the effectiveness of 10% lidocaine with 20% benzocaine as topical anesthetics in order to reduce discomfort during an EM.

MATERIALS AND METHODS

251 patients who had been prescribed an EM received either lidocaine or benzocaine in the nose and pharynx before inserting the catheter An EM was carried out using the usual pull-trough technique and an observer registered the insertion time of the catheter. Patients assessed the intensity of nasal pain and nausea by means of a visual analog scale. Finally, patients were asked whether, if necessary, they would repeat the study.

RESULTS

127 patients were studied in the lidocaine group and 124 in the benzocaine group. The EM was carried out on all patients without complications. Although benzocaine tended to be the preferred anesthetic, no significant differences were found between the groups in relation to nasal pain, nausea, and insertion time. The percentage of patients with moderate or intense discomfort was significantly less in the benzocaine group (nasal pain 10 vs. 33%, p < 0.001; and nausea 24 vs. 36%, p = 0.05). A similar percentage of patients said they would not agree to having another EM (p = NS).

CONCLUSIONS

Both lidocaine and benzocaine are topical anesthetics that can reduce discomfort during an EM. Benzocaine seems to achieve a better effect among more patients submitted to this procedure.