Author: Mao Frances
Date: December 2007
Lidocaine is a local anesthetic that is often administered intravenously or by subcutaneous injection. Recently, however, researchers from the American University of Beirut Medical Center (AUBMC) in Lebanon found a more delectable way to package lidocaine,in a lollipop. For patients undergoing upper gastrointestinal (GI) endoscopy procedures, lidocaine lollipops were found to completely eliminate the need for additional sedation. Previously, patients undergoing upper endoscopy procedures were anesthetized with a lidocaine spray. Although lidocaine lollipops have been used previously in children, they have never been reported for use by adults.
The lollipop was designed jointly by the departments of Anesthesia and Pharmacy at the American University. To make the lollipop, fifty grams of white sugar was heated until liquefaction, and equal amount of maple syrup was slowly added. After pouring 3ml of mixture into a mold, 300mg of lidocaine hydrochloride salt was added and mixed. To determine the efficacy of the lidocaine lollipop, fifty adult patients were randomly assigned to receive 300mg of lidocaine either through a spray or a lollipop. An endoscopist, who did not know which patients had received which treatment, then assessed patient discomfort through cues such as gagging, retching, restlessness and combativeness.
Overall, patients who received the lollipop gagged less, tolerated the scope more easily, and were more compliant during the procedure. "We found that 32 percent of the patients given the lidocaine lollipop required intravenous sedation compared with 96 percent of the patients who received the spray," reported first author Assaad Soweid, a physician at AUBMC.
In addition to being a safe and well-tolerated topical anesthetic, the researchers believe that usage of the lidocaine lollipop "would probably lower rates of adverse events requiring interventions, and hence lower the direct and indirect costs of the procedure." Continuous release of lidocaine from sucking the lollipop makes it efficient,facilitating a steady and continuous distribution of the anesthetic through the upper GI tract.
Written by Frances Mao
Reviewed by David Metcalfe
Published by Pooja Ghatalia.