Topical benzocaine anaesthesia lacks analgesic effects in painful non-acid oesophagitis.

BACKGROUND

No established treatment exists for pain relief in symptomatic non-acid oesophagitis. One of the most common topical anaesthetics is benzocaine which has been demonstrated to produce excellent analgesia on oral mucous membranes.

METHODS

In a prospective, placebo-controlled, balanced, single-blinded study, 26 patients with retrosternal discomfort or odynophagia due to painful non-acid oesophagitis were treated either with oral benzocaine 0.75% solution (n = 14) or with benzocaine-free solvent (placebo, n = 12) at a daily dose of 20-40 mL, for up to 6 consecutive days (median 5.5 days). During the study period patients recorded subjective pain scores for both complaints on visual analogue scales.

RESULTS

Benzocaine did not affect pain scores for any of the two symptoms, nor did it alter global subjective or objective assessment of therapy outcome in treated compared to untreated subjects (P > 0.05). There was a non-significant tendency for placebo patients to stop prematurely their study medication more often, because of lack of analgesic efficacy (P = 0.098).

CONCLUSIONS

Topical benzocaine cannot be recommended for routine symptomatic pain relief in non-acid oesophagitis. By indirect evidence, it is assumed that pain perception of non-acid oesophagitis is not preferentially mediated by superficially located mucosal nociceptors.