• T R Wolfe, D E Fosnocht, and M S Linscott.
• Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
• Ann Emerg Med. 2000 May 1; 35 (5): 421-5.

Study ObjectiveTo evaluate the efficacy of topical atomized 4% lidocaine in reducing the pain associated with nasogastric tube (NGT) placement.MethodsThis prospective, randomized, double-blind, placebo-controlled trial was conducted in the emergency department of a university teaching hospital. Study participants were alert, hemodynamically stable adult patients requiring NGT placement for diagnostic or therapeutic purposes. Atomized 4% lidocaine or normal saline solution was administered in the nasopharynx and oropharynx before NGT placement. All patients also received topical 2% lidocaine jelly intranasally after atomization. The pain of NGT placement was measured using a standard 100-mm visual analog scale.ResultsA total of 40 patients were enrolled in the study, with 20 in the lidocaine group and 20 in the placebo group. Mean pain scores were 37.4 mm (95% confidence interval [CI] 25.4 to 49.4) for atomized lidocaine and 64.5 mm (95% CI 51.8 to 77.1) for placebo with a mean difference of 27.1 mm (95% CI 14.8 to 39.4), achieving both clinical and statistical significance.ConclusionAtomized nasopharyngeal and oropharyngeal 4% lidocaine results in clinically and statistically significant reductions in pain during NGT placement.

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