{"title":"#34723利多卡因喷雾与其他形式的局部麻醉在上消化道内窥镜检查:系统回顾和荟萃分析","authors":"Theerada Chandee, Sudsayam Manuwong, Saritphat Orrapin, Neranchala Soonthornkes, Prasit Mahawongkajit, Chuleerat Suptongchai, Thanatcha Luangmaneerat","doi":"10.1136/rapm-2023-esra.398","DOIUrl":null,"url":null,"abstract":"<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant (see information at the bottom of this page) <b>Application for ESRA Abstract Prizes:</b> I don’t wish to apply for the ESRA Prizes <h3>Background and Aims</h3> Pharyngeal anesthesia before esophagogastroduodenoscopy (EGD) reduces pain and discomfort. Many forms of lidocaine are used as local anesthesia. However, it remains unclear which method is the best. We aimed to assess effective each lidocaine’s form during EGD compared with spray. <h3>Methods</h3> We searched PubMed, Scopus, EMBASE, the Cochrane Central Register of Controlled Trials, CENTRAL, Web of Science Core Collection, World Health Organization, International Clinical Trials Registry Platform, and ClinicalTrials.gov databases in December 2022. Selection criteria were randomized controlled trials comparing lidocaine spray with other forms (gel, lozenges, nebulized, popsicle, and viscous) in EGD. Outcomes of interest included ease of instrumentation, participants’ satisfaction scores, tolerance scores, or pain, endoscopist’s satisfaction scores, and procedural time. <h3>Results</h3> We included 13 trials with 3,711 participants undergoing EGD. The quality of trials was poor. Lidocaine spray provided better ease of instrumentation (Risk ratio (RR) 1.19, 95% confident intervals (CI)1.06,1.34;I2=66%;very low certainty of evidence), decreased participants’ pain (Mean difference (MD) 0.38, 95% CI 0.25,0.5;I2=92%;very low certainty of evidence), and shorter procedural time (MD 0.22, 95% CI 0.10,0.35;I2=13%;low certainty of evidence). However, spray had lower participants’ highest satisfaction scores (RR 0.83, 95% CI 0.76,0.92;I2=62%;very low certainty of evidence), participants’ mean satisfaction scores (MD -0.61, 95% CI -0.29,-0.04; I2=92%;very low certainty of evidence), participants’ tolerance scores (RR 0.83, 95% CI 0.71,0.97; I2=0%;low certainty of evidence), and endoscopist’s satisfaction scores (MD -0.33, 95% CI -0.45,-0.21;I2=94%;very low certainty of evidence). <h3>Conclusions</h3> Lidocaine spray may be better for ease of instrumentation during EGD. However, evidence is still determined due to the quality of trials.","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"#34723 Lidocaine spray versus other forms for local anesthesia in upper gastrointestinal endoscopy: A systematic review and meta-analysis\",\"authors\":\"Theerada Chandee, Sudsayam Manuwong, Saritphat Orrapin, Neranchala Soonthornkes, Prasit Mahawongkajit, Chuleerat Suptongchai, Thanatcha Luangmaneerat\",\"doi\":\"10.1136/rapm-2023-esra.398\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant (see information at the bottom of this page) <b>Application for ESRA Abstract Prizes:</b> I don’t wish to apply for the ESRA Prizes <h3>Background and Aims</h3> Pharyngeal anesthesia before esophagogastroduodenoscopy (EGD) reduces pain and discomfort. Many forms of lidocaine are used as local anesthesia. However, it remains unclear which method is the best. We aimed to assess effective each lidocaine’s form during EGD compared with spray. <h3>Methods</h3> We searched PubMed, Scopus, EMBASE, the Cochrane Central Register of Controlled Trials, CENTRAL, Web of Science Core Collection, World Health Organization, International Clinical Trials Registry Platform, and ClinicalTrials.gov databases in December 2022. Selection criteria were randomized controlled trials comparing lidocaine spray with other forms (gel, lozenges, nebulized, popsicle, and viscous) in EGD. Outcomes of interest included ease of instrumentation, participants’ satisfaction scores, tolerance scores, or pain, endoscopist’s satisfaction scores, and procedural time. <h3>Results</h3> We included 13 trials with 3,711 participants undergoing EGD. The quality of trials was poor. Lidocaine spray provided better ease of instrumentation (Risk ratio (RR) 1.19, 95% confident intervals (CI)1.06,1.34;I2=66%;very low certainty of evidence), decreased participants’ pain (Mean difference (MD) 0.38, 95% CI 0.25,0.5;I2=92%;very low certainty of evidence), and shorter procedural time (MD 0.22, 95% CI 0.10,0.35;I2=13%;low certainty of evidence). However, spray had lower participants’ highest satisfaction scores (RR 0.83, 95% CI 0.76,0.92;I2=62%;very low certainty of evidence), participants’ mean satisfaction scores (MD -0.61, 95% CI -0.29,-0.04; I2=92%;very low certainty of evidence), participants’ tolerance scores (RR 0.83, 95% CI 0.71,0.97; I2=0%;low certainty of evidence), and endoscopist’s satisfaction scores (MD -0.33, 95% CI -0.45,-0.21;I2=94%;very low certainty of evidence). <h3>Conclusions</h3> Lidocaine spray may be better for ease of instrumentation during EGD. However, evidence is still determined due to the quality of trials.\",\"PeriodicalId\":80519,\"journal\":{\"name\":\"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1136/rapm-2023-esra.398\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/rapm-2023-esra.398","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
申请ESRA摘要奖项:我不希望申请ESRA奖项背景和目的食管胃十二指肠镜检查(EGD)前的咽麻醉可以减轻疼痛和不适。许多形式的利多卡因被用作局部麻醉。然而，目前尚不清楚哪种方法是最好的。我们的目的是评估在EGD期间，与喷雾相比，每种利多卡因形式的有效性。方法于2022年12月检索PubMed、Scopus、EMBASE、Cochrane Central Register of Controlled Trials、Central、Web of Science核心合集、World Health Organization、International ClinicalTrials Registry Platform和ClinicalTrials.gov数据库。选择标准是随机对照试验，比较利多卡因喷雾与其他形式(凝胶、含片、雾剂、冰棒和粘性)在EGD中的作用。感兴趣的结果包括器械的易用性、参与者满意度评分、耐受性评分或疼痛、内窥镜医师满意度评分和手术时间。结果我们纳入了13项试验，3711名受试者接受了EGD。试验的质量很差。利多卡因喷雾提供了更好的仪器方便(风险比(RR) 1.19, 95%可信区间(CI)1.06,1.34;I2=66%;证据确定性很低)，减少了参与者的疼痛(平均差(MD) 0.38, 95% CI 0.25,0.5;I2=92%;证据确定性很低)，缩短了手术时间(MD 0.22, 95% CI 0.10,0.35;I2=13%;证据确定性很低)。然而，喷雾疗法有较低的参与者最高满意度得分(RR 0.83, 95% CI 0.76,0.92;I2=62%;证据确定性非常低)，参与者平均满意度得分(MD -0.61, 95% CI -0.29，-0.04;I2=92%，证据确定性非常低)，参与者的容忍度评分(RR 0.83, 95% CI 0.71,0.97;I2=0%，证据确定性低)和内窥镜医师满意度评分(MD -0.33, 95% CI -0.45，-0.21;I2=94%，证据确定性极低)。结论利多卡因喷雾剂在EGD中便于仪器测量。然而，由于试验的质量，证据仍然是确定的。
#34723 Lidocaine spray versus other forms for local anesthesia in upper gastrointestinal endoscopy: A systematic review and meta-analysis
Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page) Application for ESRA Abstract Prizes: I don’t wish to apply for the ESRA Prizes
Background and Aims
Pharyngeal anesthesia before esophagogastroduodenoscopy (EGD) reduces pain and discomfort. Many forms of lidocaine are used as local anesthesia. However, it remains unclear which method is the best. We aimed to assess effective each lidocaine’s form during EGD compared with spray.
Methods
We searched PubMed, Scopus, EMBASE, the Cochrane Central Register of Controlled Trials, CENTRAL, Web of Science Core Collection, World Health Organization, International Clinical Trials Registry Platform, and ClinicalTrials.gov databases in December 2022. Selection criteria were randomized controlled trials comparing lidocaine spray with other forms (gel, lozenges, nebulized, popsicle, and viscous) in EGD. Outcomes of interest included ease of instrumentation, participants’ satisfaction scores, tolerance scores, or pain, endoscopist’s satisfaction scores, and procedural time.
Results
We included 13 trials with 3,711 participants undergoing EGD. The quality of trials was poor. Lidocaine spray provided better ease of instrumentation (Risk ratio (RR) 1.19, 95% confident intervals (CI)1.06,1.34;I2=66%;very low certainty of evidence), decreased participants’ pain (Mean difference (MD) 0.38, 95% CI 0.25,0.5;I2=92%;very low certainty of evidence), and shorter procedural time (MD 0.22, 95% CI 0.10,0.35;I2=13%;low certainty of evidence). However, spray had lower participants’ highest satisfaction scores (RR 0.83, 95% CI 0.76,0.92;I2=62%;very low certainty of evidence), participants’ mean satisfaction scores (MD -0.61, 95% CI -0.29,-0.04; I2=92%;very low certainty of evidence), participants’ tolerance scores (RR 0.83, 95% CI 0.71,0.97; I2=0%;low certainty of evidence), and endoscopist’s satisfaction scores (MD -0.33, 95% CI -0.45,-0.21;I2=94%;very low certainty of evidence).
Conclusions
Lidocaine spray may be better for ease of instrumentation during EGD. However, evidence is still determined due to the quality of trials.
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