The Death of the “GI Cocktail”

Patients with epigastric pain or dyspepsia are often given “GI cocktails,” which typically contain antacid (aluminum hydroxide, magnesium hydroxide, and calcium carbonate) and lidocaine (viscous or a suspension), sometimes coupled with an antispasmodic.

In this double-blind trial, researchers in Australia randomized 89 emergency department patients with epigastric pain or dyspepsia to receive one of three mixtures: antacid alone, antacid plus lidocaine solution, or antacid plus viscous lidocaine. The primary outcome was change in pain at 30 minutes, measured on a 100-mm visual analog scale (VAS). About half of patients received other analgesic medications, but there was no difference between groups. At 30 minutes, pain scores were not signif…