The Effect of Eutectic Mixture of Local Anesthesia Cream (EMLA) on Satisfaction, Pain, and Nausea/Vomiting of Patients Undergoing Gastro-intestinal Endoscopy-A Randomized Clinical Trial Comparing EMLA Cream and Gel, Lidocaine Gel and Spray, and Placebo

BACKGROUND & OBJECTIVES: Esophagogastroduodenoscopy is a valuable diagnostic method for the treatment of various diseases that has found a wonderful application in recent years. Yet, controlling patients’ pain and nausea is a fundamental factor to increase patient satisfaction, reduce patients’ discomfort, and increase the patient’s cooperation. Therefore, this study aimed to assess the efficacy of Eutectic Mixture of Local Anesthesia (EMLA) cream and gel, as a topical pharyngeal anesthetic on patients’ pharyngeal pain, nausea/vomiting, and satisfaction, in comparison with lidocaine gel and spray and placebo.

METHODS: This double-blind randomized clinical trial was conducted to assess patient satisfaction, nausea/vomiting, throat and pharyngeal pain during and after endoscopy by different methods of local anesthesia. Thus, 150 patients were randomly divided into 5 groups of 30 receiving placebo, lidocaine gel, lidocaine spray, EMLA gel and cream 5 to 10 minutes before endoscopy. Then patient satisfaction (measured by GHAA-9 questionnaire), pain or discomfort in the throat, and nausea/vomiting were evaluated half an hour after endoscopy.

RESULTS: Patient satisfaction score was not statistically different between the test groups (P>0.05), but the throat pain and discomfort and nausea/vomiting during and after endoscopy was statistically different between groups (P<0.05) and the lowest nausea/vomiting was in the group using EMLA cream.

CONCLUSION: Different methods of throat anesthesia had no significant difference on patient satisfaction but EMLA cream and gel caused less nausea/vomiting than lidocaine gel or spray during and after endoscopy.