Effect of Lidocaine on Comfort and Swallowing Pressures During Pharyngeal High-Resolution Manometry

The purpose of this study is to determine the level of patient comfort during pharyngeal high-resolution manometry (HRM) with and without the use of atomized lidocaine. A secondary aim of the study was to explore whether differences in pharyngeal pressure measurements exist between HRM conducted with the use of atomized lidocaine verses HRM conducted without. Twenty-nine participants underwent two HRM procedures under two conditions, 5-7 days apart: 2% viscous lidocaine to nares or 0.4 mL 4% atomized and 2% viscous lidocaine to nares. During each procedure, participants received six boluses of water. Following catheter removal, participants were asked to rate comfort using a visual analog scale (VAS) and upon completion of both conditions, participants indicated which procedure they preferred. A paired t-test was used to compare pharyngeal pressure measurements at the velopharynx, tongue base region and during upper esophageal sphincter opening. Pharyngeal pressures were categorized as normal or outside of normal limits and compared using a McNemar's test. Twenty-eight of the 29 participants indicated they preferred the use of atomized lidocaine. VAS ratings yielded a significant difference (p = 0.001). No significant difference in pharyngeal pressures were detected between the two groups. Patients prefer atomized lidocaine when undergoing HRM. The use of atomized lidocaine did not affect measurement outcomes.