[Usefulness of gel lidocaine in esophageal manometry]

Esophageal manometry (EM) is a functional study performed without sedation. The insertion of a catheter through nasal passages provokes the greatest discomfort as it is being performed.

To evaluate the usefulness of lidocaine jelly to diminish discomfort patient during EM and to ease the procedure.

Ninety patients sent to EM were randomly assigned to receive lidocaine jelly at 2% (n = 45) or chlorexidine gluconate (n = 45) as a lubricant for the catheter. A solid-state catheter was employed via the pull-through technique under topic anesthesia of the hypopharynx in all cases. Patients quantified nasal pain and nausea produced by analog visual scale (AVS, 0-10 cm). The physician quantified difficulty of insertion using the same method. An independent observer kept time records from the moment of insertion of the probe through the nasal passages until the location of all sensors in the stomach (time of insertion).

No significant differences were found between the two groups in their evaluation of nasal pain (2.8 cm lidocaine group vs. 2.6 cm chlorhexidine group), and there was no difference found in the intensity of nausea (3.3 cm vs. 3.1, respectively). Ease of the procedure was similar (2.2 cm lidocaine group vs. 1.8 cm chlorhexidine group), as well as insertion time (120 vs. 111 sec, respectively).

Lidocaine jelly at 2% neither diminishes the discomfort provoked by the insertion of an EM catheter, nor does it make the procedure any easier.