An audit of lidocaine spray and its use in endoscopy with particular attention to its ethanol content

Objective: The aim was to investigate the attitude of patients about to undergo upper gastrointestinal endoscopy toward the use of an oral lidocaine spray which contained alcohol. Materials and Method: It is customary to offer patients about to undergo a gastroscopy intravenous sedation, an oral local anesthetic spray or a combination of both. However, the presence of alcohol within the oral spray is seldom discussed with patients. There are some religious groups, such as fundamentalist Christians and Muslims, who will only consider the use of alcohol in exceptional circumstances. There are also others who are reluctant to use it for a range of reasons. One hundred patients undergoing a diagnostic gastroscopy because of dyspeptic symptoms at the University Hospitals of Leicester were provided with an information sheet about sedation. Of the 100 patients asked to take part in the audit 25 were South Asian. Eleven of these patients were Muslim and 11 Hindu. Results: Fifteen patients declined to use the spray (13 Europeans and 2 South Asians). The reasons varied with only two doing so for religious reasons. One of the patients was a Muslim and the other a Christian. However, almost 90% of people believed all patients should be told of the alcohol content of the oral spray so as to allow them to make an informed choice. Conclusion: All patients who are to undergo an endoscopy should be told of the alcohol content of any oral anesthetic spray, so that they can make an informed choice as to whether they wish to receive it.