Nasrallah S M, Hendrix E
Am J Gastroenterol. 1987 Jun;82(6):523-5.
A strong gag reflex may be a limiting factor to perform esophageal motility in some patients. Even though local anesthetics could alleviate such a problem, they are not used for fear of interfering with various manometric parameters. In this study, we evaluated the effect of topical pharyngeal local anesthesia on lower esophageal sphincter pressure, amplitude, duration, and velocity of esophageal contractions. We also studied its effects on the patient's tolerance. Esophageal motility was performed before and after topical anesthesia with 20% benzocaine. The baseline tracing and the tracing obtained after topical anesthesia were number coded and separated. They were evaluated blindly as to the pressure in the lower esophageal sphincter, amplitude, duration, and velocity of esophageal contractions. An average of 10 wet swallows was used to determine the above values. There was no significant change in the lower esophageal sphincter pressure or the amplitude of esophageal contractions after benzocaine. Similarly, there was no change in the duration or velocity of peristaltic activity. The patient's tolerance to the tube was unchanged or improved in 12 of 14 patients. Six patients had some difficulty in swallowing, but were able to compensate by sucking on the syringe. Our results indicate that topical pharyngeal anesthesia does not affect the usually measured manometric parameters; and while it may improve the patient's tolerance to the manometric catheter, it interferes with the ability to swallow.
在一些患者中，强烈的 gag 反射可能是进行食管动力检查的限制因素。尽管局部麻醉剂可以缓解这一问题，但由于担心干扰各种测压参数，它们并未被使用。在本研究中，我们评估了咽部局部麻醉对食管下括约肌压力、食管收缩幅度、持续时间和速度的影响。我们还研究了其对患者耐受性的影响。在使用 20%苯佐卡因进行局部麻醉前后进行食管动力检查。将基线描记图和局部麻醉后获得的描记图进行编号编码并分开。对食管下括约肌压力、食管收缩幅度、持续时间和速度进行盲法评估。平均进行 10 次湿咽以确定上述值。使用苯佐卡因后，食管下括约肌压力或食管收缩幅度没有显著变化。同样，蠕动活动的持续时间或速度也没有变化。14 名患者中有 12 名患者对导管的耐受性未改变或有所改善。6 名患者吞咽时有一些困难，但能够通过吸吮注射器来代偿。我们的结果表明，咽部局部麻醉不会影响通常测量的测压参数；虽然它可能会提高患者对测压导管的耐受性，但会干扰吞咽能力。
