ประสิทธิภาพและความปลอดภัยของยาชาเฉพาะที่สองขนาดในการเตรียมผู้ป่วยโรคหัวใจและหลอดเลือดเพื่อการตรวจคลื่นเสียงสะท้อนหัวใจผ่านหลอดอาหาร: การทดลองแบบสุ่มที่มีกลุ่มควบคุม ณ ศูนย์หัวใจสิริกิติ์ ภาคตะวันออกเฉียงเหนือ มหาวิทยาลัยขอนแก่น

Phuangpaka  Ungprasert; Chitrada Ungprasert; Jeeraporn  Khurirang

doi:10.64960/srimedj.v41i4.271158

Authors

Phuangpaka Ungprasert Division of Cardiology, Faculty of Medicine, Khon Kaen University, Muang District, Khon Kaen Province, Thailand 40002
Chitrada Ungprasert Division of Cardiology, Faculty of Medicine, Khon Kaen University, Muang District, Khon Kaen Province, Thailand 40002
Jeeraporn Khurirang Queen Sirikit Heart Center of the Northeast, Faculty of Medicine, Khon Kaen University, Muang Dristrict, Khon Kaen Province, Thailand 40002

DOI:

https://doi.org/10.64960/srimedj.v41i4.271158

Keywords:

transesophageal echocardiography, local anesthesia lidocaine, lidocaine dose, local anesthetic systemic toxicity

Abstract

Background and objective: Transesophageal echocardiography (TEE) is used to evaluate cardiovascular patients. Before the procedure, patients are prepared by administering local anesthetic drug to the oral cavity and pharynx. This study aimed to compare the effects of two doses of local anesthetic in order to evaluate efficacy, safety, and drug-related side effects.

Methods: This study was a randomized controlled trial that divided patients undergoing TEE into two groups. One was the intervention group, which received a lower dose local lidocaine, and the other was the control group. The study was conducted from 16 June 2024 to 30 April 2025. The primary outcomes was the success rate of TEE insertion, and secondary outcomes were complications during TEE insertion and side effects of lidocaine.

Results: 70 patients were enrolled, the intervention group of 36 and control group of 34. The mean age of patients in the intervention group and control group were 51.1 ± 16.2 yrs and 53.7 ± 12.0 yrs, respectively. Most patients had Modified Mallampati class I or II airway. Total lidocaine dose was 85.0 ± 7.4 mg in the intervention group and 201.2 ± 4.1 mg in the control group, although 10% lidocaine spray was more frequently required in the intervention group (p = 0.007). TEE insertion was successful in both groups. There were no complications during TEE insertion, however side effects of lidocaine were more commonly found in the control group such as bitter taste and perioral paresthesia (p < 0.001).

Conclusions: An intervention group, which used lower dose of local lidocaine, was effective for preparation before TEE, with comparable efficacy to the control group. TEE insertion was successful, with no complications and no drug-related side effects observed.

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