Use of Nebulized Lidocaine for Nasogastric Tube Insertion - Pros and cons
A double-blind, placebo-controlled, randomized clinical trial of adult patients was conducted in the EDs of 2 university hospitals. 29 participants were administered nebulized lidocaine (4 mL 10%), and 21 participants received nebulized normal saline solution *. Patient discomfort was measured using a 100-mm visual analog scale. The difficulty of nasogastric tube insertion was evaluated using a 5-point Likert scale.
Results:
- There was a clinical and statistical significant difference in patient discomfort associated with the passage of the nasogastric tube between nebulized lidocaine and placebo groups (mean visual analog scale score 37.7 versus 59.3 mm, respectively).
- There was not a detectable difference in difficulty with the passage of the nasogastric tube between the 2 groups
- Epistaxis occurred more frequently in the lidocaine group
Conclusion: Nebulized lidocaine decreases the discomfort of nasogastric tube insertion and should be considered before passing a nasogastric tube. An increased frequency of epistaxis, however, may be associated with its use.
* Four milliliters of the trial solution was administered using a face mask and a compressed gas-powered jet nebulizer with an oxygen flow rate of 6 L/min. The patient was instructed to breathe through his or her nose and mouth while the solution was being nebulized. Immediately after the nebulization was completed, the nurse removed the mask and inserted the nasogastric tube with the usual lubrication gel (KY Jelly) in the normal manner.
Reference: Click to get abstract
Nebulized Lidocaine Decreases the Discomfort of Nasogastric Tube Insertion: A Randomized, Double-Blind Trial - [Ann Emerg Med. 2004;44:131-137.]
