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Torabi MM, Shoorgashti R, Haji Fattahi F, Lesan S. Evaluation of the Effect of Benzydamine Hydrochloride on the Intensity of Gag Reflex: A Randomized Single-Blind Clinical Trial. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2024; 25:162-168. [PMID: 38962077 PMCID: PMC11217069 DOI: 10.30476/dentjods.2023.97675.2032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/21/2023] [Accepted: 08/27/2023] [Indexed: 07/05/2024]
Abstract
Statement of the Problem Gag reflex is among the most common problems during dental and endoscopic procedures. Benzydamine hydrochloride is a non-steroidal anti-inflammatory medication and a local anesthetic that might be useful in reducing the gag reflex. Purpose This study aimed to evaluate the effects of benzydamine hydrochloride mouthwash on the intensity of the gag reflex. Materials and Method In this randomized clinical trial study, 30 participants aged 21-26 with a gag trigger point index (GTPI) higher than 2 were divided into 2 groups. In the case group, 15 ml of 0.15% benzydamine hydrochloride mouthwash was gargled for 1 minute, and after 10 minutes GTPI test was conducted. In the control group, 4 puffs of 10% lidocaine spray were applied to the mucosa of the targeted area, and after 5 minutes, GTPI was measured. Participants were asked about the taste and smell of the medications. Results GTPI was significantly reduced in both groups. In the lidocaine group, the GTPI score changed from 4.47 to 2.00 (p< 0.001), and that for the benzydamine group was 4.20 to 1.47 (p< 0.001). The variance rate of the gag reflex was -2.73 and -2.47 in the benzydamine group and lidocaine group, respectively. However, this reduction was not statistically significant between the two groups. Moreover, benzydamine mouthwash has a significantly better taste and smell than lidocaine (p= 0.001). Conclusion The results of this study showed that benzydamine mouthwash could be used quite effectively in reducing the gag reflex.
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Affiliation(s)
| | | | - Farnaz Haji Fattahi
- Dept. of Oral Medicine, Islamic Azad University of Medical Sciences, Dental Branch, Tehran, Iran
| | - Simin Lesan
- Dept. of Oral Medicine, Islamic Azad University of Medical Sciences, Dental Branch, Tehran, Iran
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Matsumoto K, Imagawa A, Ueda N, Watabe H, Ikebuchi Y, Kurumi H, Sasaki YU, Abe Y, Abe R, Mabe K, Noma H, Fujiwara K, Ueki M, Fujishiro M, Isomoto H. Acceptability, Safety, and Feasibility of Transnasal and Peroral Ultrathin Endoscopy Using GAGLESS Mouthpieces: A Prospective Randomized Trial. In Vivo 2024; 38:826-832. [PMID: 38418116 PMCID: PMC10905482 DOI: 10.21873/invivo.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND/AIM Esophagogastroduodenoscopy (EGD) is an effective screening method for early detection of gastric cancer. The GAGLESS mouthpiece has a structure that widens the pharyngeal cavity and suppresses the pharyngeal reflex. This study aimed to investigate the acceptability, safety, and feasibility of transnasal and peroral ultrathin endoscopy using GAGLESS mouthpieces (Clinical Trial Number: UMIN000036922). PATIENTS AND METHODS This study was a multicenter, prospective, randomized, open-label trial performed using a questionnaire. The study included 101 consecutive patients who visited the participating medical institutions between June 2019 and March 2022 (median age=47 years, range=24-87 years; all male). Patients aged ≥20 years at the time of consent acquisition who were the first to undergo EGD were included in the study. The primary endpoint was the degree of distress during EGD, as determined using a visual analog scale (VAS). RESULTS The VAS score during endoscopic passage through the pharynx was significantly better in the transnasal endoscopy group than in the oral endoscopy group (2.420 vs. 4.092, p=0.001). There was no significant difference in the VAS scores between the two groups during anesthesia or throughout the examination. Compared with nasal endoscopy, oral endoscopy with a GAGLESS mouthpiece did not reduce the VAS score but did significantly improve gastric visibility. CONCLUSION For patients in whom there was difficulty in inserting a nasal endoscope, using a GAGLESS mouthpiece rather than a conventional mouthpiece may be more useful in reducing pain.
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Affiliation(s)
- Kazuya Matsumoto
- Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Yonago, Japan;
- Irisawa Medical Clinic, Matsue, Japan
| | | | - Naoki Ueda
- Yasugi Municipal Hospital, Yasugi, Japan
| | | | - Yuichiro Ikebuchi
- Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Hiroki Kurumi
- Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Y U Sasaki
- Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yasuhiko Abe
- Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan
- Division of Endoscopy, Yamagata University Hospital, Yamagata, Japan
| | - Ryo Abe
- Yonago Chuo Clinic, Yonago, Japan
| | - Katsuhiro Mabe
- Junpukai Health Maintenance Center Kurashiki, Kurashiki, Japan
| | - Hisashi Noma
- Department of Data Science, The Institute of Statistical Mathematics, Tachikawa, Japan
| | - Kazunori Fujiwara
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Masaru Ueki
- Division of Medical Education, Department of Medical Education, Tottori University Faculty of Medicine, Yonago, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hajime Isomoto
- Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Yonago, Japan
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Ikebuchi Y, Matsumoto K, Ueda N, Yamashita T, Kurumi H, Onoyama T, Takeda Y, Yoshida A, Kawaguchi K, Yashima K, Fujiwara K, Imamoto R, Noma H, Ueki M, Isomoto H. Efficacy and Safety of a Novel Mouthpiece for Esophagogastroduodenoscopy: A Multi-Center, Randomized Study. Diagnostics (Basel) 2021; 11:diagnostics11030538. [PMID: 33802944 PMCID: PMC8002750 DOI: 10.3390/diagnostics11030538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 12/24/2022] Open
Abstract
This randomized trial aimed to compare the safety and efficacy of the GAGLESS mouthpiece for esophagogastroduodenoscopy (EGD) with that of the conventional mouthpiece. In all, 90 participants were divided into the GAGLESS mouthpiece and conventional mouthpiece groups. The primary endpoint was the severity of pain using the visual analog scale (VAS), and secondary endpoints were examination time, past history of endoscopy, success of the procedure, systolic (SBP) and diastolic (DBP) blood pressure, oxygen saturation, pulse rate before and after EGD, and adverse events. Endoscopy was completed in all cases, and no complications were observed. VAS, when passing the scope through the pharynx, was 2.5 ± 2.4 and 2.0 ± 1.9 cm (p = 0.24) in the conventional and GAGLESS groups, respectively, and that, throughout the examination, was 2.5 ± 2.4 and 1.7 ± 1.5 cm (p = 0.06), respectively. The difference in blood pressure between the GAGLESS and conventional groups was not significant for SBP (p = 0.08) and significant for DBP (p = 0.03). The post-EGD difference in DBP was significantly lower in the GAGLESS group than in the conventional group. The results indicate that GAGLESS mouthpieces had a lower VAS during endoscopy than the conventional mouthpieces, and the changes in blood pressure were smaller with the GAGLESS mouthpiece.
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Affiliation(s)
- Yuichiro Ikebuchi
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan; (T.Y.); (H.K.); (T.O.); (Y.T.); (A.Y.); (K.K.); (K.Y.)
- Correspondence: (Y.I.); (K.M.)
| | - Kazuya Matsumoto
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan; (T.Y.); (H.K.); (T.O.); (Y.T.); (A.Y.); (K.K.); (K.Y.)
- Irisawa Medical Clinic, Shimane 690-0025, Japan;
- Correspondence: (Y.I.); (K.M.)
| | - Naoki Ueda
- Irisawa Medical Clinic, Shimane 690-0025, Japan;
- Department of Gastroenterology, Yasugi Municipal Hospital, Shimane 692-0404, Japan; (R.I.); (H.I.)
| | - Taro Yamashita
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan; (T.Y.); (H.K.); (T.O.); (Y.T.); (A.Y.); (K.K.); (K.Y.)
| | - Hiroki Kurumi
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan; (T.Y.); (H.K.); (T.O.); (Y.T.); (A.Y.); (K.K.); (K.Y.)
| | - Takumi Onoyama
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan; (T.Y.); (H.K.); (T.O.); (Y.T.); (A.Y.); (K.K.); (K.Y.)
| | - Yohei Takeda
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan; (T.Y.); (H.K.); (T.O.); (Y.T.); (A.Y.); (K.K.); (K.Y.)
| | - Akira Yoshida
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan; (T.Y.); (H.K.); (T.O.); (Y.T.); (A.Y.); (K.K.); (K.Y.)
| | - Koichiro Kawaguchi
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan; (T.Y.); (H.K.); (T.O.); (Y.T.); (A.Y.); (K.K.); (K.Y.)
| | - Kazuo Yashima
- Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan; (T.Y.); (H.K.); (T.O.); (Y.T.); (A.Y.); (K.K.); (K.Y.)
| | - Kazunori Fujiwara
- Department of Otolaryngology, Head and Neck Surgery, Division of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan;
| | - Ryu Imamoto
- Department of Gastroenterology, Yasugi Municipal Hospital, Shimane 692-0404, Japan; (R.I.); (H.I.)
| | - Hisashi Noma
- The Institute of Statistical Mathematics, Tokyo 190-8562, Japan;
| | - Masaru Ueki
- Advanced Medicine, Innovation and Clinical Research Center, Tottori University Hospital, Tottori 683-8504, Japan;
| | - Hajime Isomoto
- Department of Gastroenterology, Yasugi Municipal Hospital, Shimane 692-0404, Japan; (R.I.); (H.I.)
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