No effect of perianal application of topical anaesthetic on patient comfort during nonsedated flexible sigmoidoscopy: a randomized, placebo-controlled clinical trial.

Aim: A literature review revealed no data on the effects of topical anaesthetic on patient comfort during flexible sigmoidoscopy. We therefore aimed to evaluate this in a randomized manner.

Method: One hundred and forty-six patients who underwent flexible sigmoidoscopy were randomly allocated to one of three groups. Vaseline (n = 49), 2% lidocaine gel (n = 51) or a cream of 2.5% lidocaine plus 2.5% prilocaine (n = 46) were applied to the patients 30 min before the procedure. Demographic data and haemodynamic monitoring during procedures were recorded. Pain was assessed by visual analogue scale (VAS) and anxiety levels by the State-Trait Anxiety Inventory (STAI-I and STA-II).

Results: Median pre-procedural STAI-I scores were 45, 46 and 40.5 and median post-procedural STAI-I scores were 35, 34 and 33.5 for the vaseline, lidocaine, and lidocaine/prilocaine treatments, respectively. There was no statistical difference among the groups in terms of STAI-I and II scores. However, post-procedural STAI-I scores were significantly lower than pre-procedural values in each group (P < 0.001). There was no significant difference in VAS scores among the groups. In all groups there were statistically higher VAS scores during the procedure compared with the pre- and post-procedural scores (P < 0.001).

Conclusion: Perianal application of topical anaesthetic does not influence patient comfort during sigmoidoscopy.