Should lidocaine spray be used to ease nasogastric tube insertion? A double-blind, randomised controlled trial.

OBJECTIVE To investigate the efficacy and safety of lidocaine nasal spray before nasogastric tube insertion in an emergency department. DESIGN Double-blind, randomised controlled study. SETTING Emergency department of a major regional hospital in Hong Kong. PATIENTS A total of 206 adult patients, for whom nasogastric tube insertion was indicated. MAIN OUTCOME MEASURES Primary outcome was discomfort gauged on a visual analogue scale, and Likert scale addressing difficulty of nasogastric tube insertion. RESULTS Compared with placebo spray use, lidocaine spray use was associated with less patient discomfort, and less difficulty in nasogastric tube insertion, both difference being statistically significant. CONCLUSION Intranasal lidocaine spray before nasogastric tube insertion was safe and effective in reducing patient discomfort related to the procedure.