The following is a summary of “Topical Pharyngeal Anesthesia in Sedated Pediatric Patients Undergoing Esophagogastroduodenoscopy,” published in the May 2023 issue of Pediatrics by Aljabari, et al.

For a single-center, retrospective, observational cohort study, researchers sought to investigate the impact of adding a topical pharyngeal anesthetic (TPA) to propofol-based sedation on the rate of airway incidents and adverse events (AIAE) during esophagogastroduodenoscopy (EGD) in pediatric patients.

The study compared the rates of AIAE (including coughing, gagging, apnea, airway obstruction, and laryngospasm) in two groups of children who underwent EGD with procedural sedation: one group received TPA as part of the sedation regimen, while the other group did not receive TPA. The data were collected retrospectively from a single center.

In 2021, a total of 73 patients received TPA as part of their procedural sedation for EGD, while 123 patients did not receive TPA. The overall rate of AIAE was high, with 75 (38%) patients experiencing one or more AIAE. The group that received benzocaine spray as the TPA had a higher rate of AIAE compared to the control group [adjusted odds ratio (aOR) = 1.16; 95% CI: 1.01-1.34; P = 0.037]. However, there were no significant differences between the groups in terms of coughing, gagging, apnea with desaturation rates, and laryngospasm (coughing aOR = 1.01; 95% CI: 0.91-1.13; P = 0.814; gagging aOR = 1.01; 95% CI: 0.91-1.13; P = 0.814; apnea aOR = 0.99; 95% CI: 0.95-1.04; P = 0.688; laryngospasm OR = 1.01; 95% CI: 0.95-1.07; P = 0.71). The rate of airway obstruction requiring jaw thrust was slightly higher in the benzocaine group but did not reach statistical significance (aOR = 1.11; 95% CI: 0.97-1.26; P = 0.133).

The administration of topical pharyngeal benzocaine in children undergoing EGD with propofol-based sedation was associated with a higher overall rate of AIAE. However, most of the incidents were mild, and only a small number of patients experienced true adverse events.

Source: journals.lww.com/jpgn/Abstract/2023/05000/Topical_Pharyngeal_Anesthesia_in_Sedated_Pediatric.19.aspx