Topical anesthesia with 50 mg of lidocaine spray facilitates upper gastrointestinal endoscopy.

To investigate the value of 50 mg of topical lidocaine spray in upper gastrointestinal endoscopy, a randomized double-blind placebo-controlled study was undertaken with 50 mg of lidocaine spray as the active treatment. All patients were sedated with diazepam after administration of the spray. Included in the study were 158 consecutive patients aged 18 years or older being treated at the endoscopy unit of Scunthorpe district general hospital. Tolerance to upper gastrointestinal endoscopy as assessed by endoscopists and patients was evaluated. Of the 158 patients, 85 received the placebo spray and 73 the lidocaine spray. Patient acceptability for upper gastrointestinal endoscopy was significantly greater in the lidocaine group than in the placebo group (p = 0.001), and tolerance to the procedure as assessed by the endoscopist was also significantly greater in the lidocaine group than in the placebo group (p = 0.008). We conclude that topical anesthesia with 50 mg of lidocaine spray facilitates upper gastrointestinal endoscopy for the endoscopist and increases patient tolerance for the procedure.