Redefining the Role of Ketamine for Topicalisation and its Comparison with the Legend Lignocaine for Oesophagogastroduodenoscopies- A Randomised Clinical Study

Introduction: Endoscopy is a minimally invasive procedure for visualisation of gastrointestinal tract performed under topicalisation with or without sedation. Lignocaine is one of the most popular local anaesthetic used for topicalisation for endotracheal intubation in different forms like spray, gargles, nebulisation, gel. Recently ketamine has emerged as an effective antinociceptive and anti-inflammatory agent. Aim: To observe and compare the effect of ketamine and lignocaine gargles for decreasing sore throat, coughing and change in voice. Also to observe various side-effects following use of ketamine and lignocaine. Materials and Methods: This prospective double-blind randomised clinical trial was conducted at Shree Krishna Hospital, Karamsad, Gujarat, India, from January 2020 to June 2021. Total 70 patients undergoing oesophagogastroduodenoscopies under sedation were included in the study. They were divided into two groups i.e, 35 patients in each group. Group L received lignocaine 2% viscous gargles 3 mg/kg and group K received ketamine gargles 3 mg/kg ideal body weight diluted in Normal Saline (NS) up to total 30 mL. Sore throat, coughing, change in voice, side-effects were observed. Student’s t-test was used for continuous data. Results: In group L, 11.4% of patients and in group K 22.9% of patients complained of mild sore throat (grade 1) immediate postprocedure but this was statistically insignificant (p-value=0.2). For both the groups, grade 1 coughing was observed in 2.9% patients (p-value >0.995). In both the groups 5.71% of patients complained about change of voice, statistically insignificant (p-value >0.995). Vomiting was observed as a side-effect in 2.9% of patients in both the groups but there were no other side-effects. Conclusion: Gargling with ketamine was as effective as lignocaine for prevention of sore throat, coughing and change in voice in patients undergoing oesophagogastroduodenoscopies and thus improved patient compliance.