Basturk Ahmet, Artan Reha, Yılmaz Aygen
Department of Pediatric Gastroenterology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
Pediatr Gastroenterol Hepatol Nutr. 2017 Jun;20(2):87-93. doi: 10.5223/pghn.2017.20.2.87. Epub 2017 Jun 28.
Our aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children.
The endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion.
Sedation was not applied in 24.1% of the cases in topical lidocaine spray group (LS group) and in 5.7% of the cases in distilled water spray group (DS group). Gag reflex was observed in 6.5% of cases in LS group and 33.3% of cases in DS group (=0.024), increased oral secretion was observed in 9.3% of cases in LS group and 51.7% of cases in DS group (=0.038), sore throat was observed in 3.7% of cases in LS group and 35.6% of cases in DS group (=0.019) and the difference was statistically significant.
The study showed that topical pharyngeal lidocaine reduces both requirement and amount of IV sedation before EGD in children and sore throat, gag reflex and decreased oral secretion increase.
本研究旨在探讨局部应用利多卡因喷雾剂在儿童镇静下食管胃十二指肠镜检查（EGD）中的疗效。
对在我们内镜科接受EGD检查的3至18岁儿童进行内镜检查。静脉注射咪达唑仑和氯胺酮进行镇静。在镇静前，内镜护士以双盲方式，在第1组以1mg/kg的剂量用泵式喷雾器局部应用10%利多卡因，在第2组用同样规格的泵式喷雾器应用蒸馏水。
局部应用利多卡因喷雾剂组（LS组）24.1%的病例未应用镇静，蒸馏水喷雾组（DS组）5.7%的病例未应用镇静。LS组6.5%的病例观察到咽反射，DS组33.3%的病例观察到咽反射（P=0.024）；LS组9.3%的病例观察到口腔分泌物增加，DS组51.7%的病例观察到口腔分泌物增加（P=0.038）；LS组3.7%的病例观察到咽痛，DS组35.6%的病例观察到咽痛（P=0.019），差异具有统计学意义。
该研究表明，局部应用咽部利多卡因可减少儿童EGD前静脉镇静的需求和用量，并可减轻咽痛、咽反射及减少口腔分泌物增加。
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