Perianal lidocaine application during unsedated colonoscopy: A double-blind randomized controlled trial

Area of Science:

• Gastroenterology
• Anesthesiology
• Endoscopy

Background:

• Unsedated colonoscopy can cause patient discomfort and procedural challenges.
• Perianal lidocaine is explored as a method to mitigate these issues.

Purpose of the Study:

• To evaluate the impact of perianal lidocaine on patient comfort and procedural efficiency during unsedated colonoscopy.
• To assess pain reduction, intubation time, detection rates, and adverse events.

Main Methods:

• 122 patients (18-40 years) were randomized to receive either 2% lidocaine or normal saline applied perianally.
• Pain scores (anal and abdominal) were measured using a visual analogue scale (VAS).
• Cecal intubation time, polyp/adenoma detection rates, and adverse events were recorded.

Main Results:

• Lidocaine significantly reduced anal pain during and after the procedure compared to saline.
• Abdominal pain scores post-colonoscopy were lower in the lidocaine group.
• Cecal intubation time decreased, and polyp/adenoma detection rates increased with lidocaine use.
• Improvements were more pronounced with junior endoscopists.

Conclusions:

• Perianal lidocaine application is effective in reducing anal pain during unsedated colonoscopy.
• It enhances procedural efficiency and detection rates, especially for less experienced endoscopists.
• Lidocaine offers a promising strategy for improving the unsedated colonoscopy experience.