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Updated: Jul 1, 2025

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
Published on: January 13, 2017
Topical pharyngeal anesthesia with articaine for gastroscopy: a double-blinded, randomized cross-over study in
Niklas Mattila1, Maxim Mazanikov1, Marianne Udd2
1Department of Perioperative and Intensive Care Medicine, Faculty of Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Objectives:
The benefits of topical pharyngeal anesthesia for gastroscopy remain under debate. Articaine, a local anesthetic with fast onset and offset of action as well as low systemic toxicity, could be a promising choice for topical anesthesia. The objective of this study was to assess whether topical pharyngeal anesthesia with articaine is beneficial in sedated gastroscopy.
Materials And Methods:
This randomized double-blinded cross-over study included nine volunteers who underwent two gastroscopies under conscious sedation. One was performed with topical pharyngeal anesthesia with articaine and the other with placebo. Hemodynamic parameters including autonomic nervous system state were recorded prior to and during the endoscopic procedure. The endoscopist and the volunteer assessed the endoscopy after the examination.
Results:
Topical pharyngeal anesthesia with articaine resulted in less discomfort during esophageal intubation and higher patient satisfaction with the procedure. Topical pharyngeal anesthesia with articaine did not increase satisfaction or facilitate the procedure as rated by the endoscopist. There were no clinically relevant differences in hemodynamic parameters.
Conclusion:
The use of articaine for topical pharyngeal anesthesia results in less intubation-related discomfort and better satisfaction.
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