DOI: 10.36347/sajb.2016.v04i11.002

Pages: 970-974

Nasogastric intubation is a common painful procedure performed in emergency department that physicians rarely consider need for topical anaesthetic agent prior to the procedure. This study investigated the effectiveness and safety of nebulized Lidocaine as topical anaesthetic agent to upper aero-digestive tract prior to nasogastric tube insertion. The study prospectively randomized 78 adult patients in emergency department of a tertiary health institution with indications for nasogastric tube insertion. The study consisted of two groups, the nebulized group (NEBG) whose each nostril and oropharynx were nebulized with 1% to 4% Lidocaine and placebo group (PLAG) whose each nostrils and oropharynx were also nebulized with normal saline. The sociodemographic characteristics and the indications for Nasogastric (NG) tube insertion for the two groups were similar. The mean change in pulse rate was lower in NEBG (5.4 vs 10, p <0.001) as well as mean change in respiratory rate (2.6 vs 5, p <0.001) and both showed statistical significant difference. The mean discomfort score on VAS, mean difficulty level on likert scale, mean insertion time and failure rate were all lower in NEBG compared to the PLAG (3.4 vs 6.7, p< 0.001), (1.3 vs 3.8 p < 0.001), (96.4 sec vs 246.90sec p < 0,001) and (13.3% vs 46.7% p =0.011) respectively. The NEBG group experienced more tracheal intubation though not statistically significant (8 (20.5%) vs 3(7.7%), p = 0.1932). We thus concluded that nebulized lidocaine is safe and effective topical anaesthetic agent to upper aero-digestive tract prior to nasogastric tube insertion, with clinical evidence and statistical significant decrease in discomfort associated with the procedure.