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Patients may have sweet and effective way to prepare for upper GI endoscopy: an anesthetic lollipop
Date:10/16/2007

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Lollipops have been successfully used to provide anesthesia to children before painful procedures. The concept of using a lidocaine lollipop as a single-agent anesthetic in upper endoscopy is novel and has not been reported in medical literature. Medications to achieve sedation, however, may cause potential side effects such as respiratory depression, hypotension (low blood pressure) and paradoxical agitation, in which the patient becomes agitated rather than sleepy from the sedation. These side effects happen more so in elderly patients and those with comorbid illnesses.

The lollipop used in this study was developed by the anesthesia department in collaboration with the pharmacy department at AUBMC. Fifty grams of white sugar were heated until liquefied; an equal amount of golden maple syrup was slowly added. For each lollipop, 3 mL of this mixture were poured into a small cylindric container, to which 300 mg of lidocaine hydrochloride salt was added and stirred. As the the mixture cooled and solidified, a small plastic stick was plunged at one end for holding the lollipop. The ready-to-use lollipops were then labeled and stored in a refrigerator.

Patients and Methods

Fifty patients, 18 years of age and older with no allergies to lidocaine, were seen at the American University of Beirut Medical Center for elective diagnostic upper endoscopy. The single-blinded study participants were randomly assigned to receive 300 mg of lidocaine in the form of either a lollipop or as a spray. In both study groups, the decision to administer intravenous sedation was based on the blinded endoscopists assessment of patient discomfort (excessive gagging, retching, restlessness and combativeness) during any part of the procedure.

Immediately after the procedure, the endoscopist filled in a questionnaire rating the quality of the procedure, the tolerability of the patient, the doses of additional sedatives used, and the level of the patie
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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