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BACKGROUND There have been conflicting reports about the usefulness of topical pharyngeal anesthesia as a pre-endoscopic medication. OBJECTIVE To assess the effect of topical pharyngeal anesthesia without intravenous sedatives on easing upper gastrointestinal endoscopy. METHODS 153 consecutive consenting patients were randomized to receive either placebo (normal saline) spray (78 patients) or 80 mg of 4% lidocaine spray (75 patients). Difficulty of intubation was judged both by the patient and the physician on a linear analogue scale. RESULTS There was no significant difference in the scores in the two groups (p > 0.05). The patient and physician assessments correlated well. CONCLUSIONS Topical lignocaine spray does not facilitate upper gastrointestinal endoscopy in the absence of intravenous sedation.
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