Effect of Lidocaine on Swallowing During FEES in Patients With Dysphagia

Ann Otol Rhinol Laryngol. 2015 Jul;124(7):537-44. doi: 10.1177/0003489415570935. Epub 2015 Feb 9.

Abstract

Purpose: The aims of this study were to assess the effects of 0.2 mL of 4% atomized lidocaine on swallowing and tolerability during Fiberoptic Endoscopic Evaluation of Swallowing (FEES).

Methods: A single blinded study was conducted with 17 dysphagic patients, who received 4 standardized boluses in 2 sequential FEES exams under 2 conditions: non-anesthetized (decongestant only) and anesthetized (lidocaine 4%+decongestant). After each procedure, patients rated their pain on the Wong Baker FACES Pain Rating Scale. Clinicians scored each swallow with the Penetration Aspiration Scale (PAS) and an author-developed Residue Rating Scale. Because the assessments were ordinal, a series of Wilcoxon signed-rank tests were conducted to detect differences between the 2 conditions.

Results: No significant differences were detected between groups on PAS or residue in the 4 boluses. Pain scores, however, were significantly lower in the anesthetized condition than the decongested-only condition (P=.035).

Conclusion: The findings of this study indicated that 0.2 mL of 4% lidocaine enhanced exam tolerability and did not impair the swallow in dysphagic patients.

Keywords: FEES; aspiration; patient comfort; penetration; topical anesthetic.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Topical
  • Aged
  • Aged, 80 and over
  • Anesthetics, Local / administration & dosage
  • Deglutition / drug effects*
  • Deglutition / physiology
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / physiopathology*
  • Endoscopes, Gastrointestinal*
  • Endoscopy, Gastrointestinal / methods*
  • Equipment Design
  • Fiber Optic Technology / instrumentation*
  • Humans
  • Lidocaine / administration & dosage*
  • Middle Aged
  • Patient Satisfaction
  • Single-Blind Method

Substances

  • Anesthetics, Local
  • Lidocaine