Local Anesthesia Versus Placebo in Flexible Nasopharyngo-laryngoscopy -
DOI:
https://doi.org/10.12970/2308-7978.2013.01.01.10Keywords:
Flexible nasopharyngolaryngoscopy, normal saline, topical anesthesia.Abstract
Background: The flexible nasopharyngolaryngoscopy is the commonest procedure in both out patients and in patients for the diagnosis of diseases. Since this procedure is at best uncomfortable and at worst intolerable making the procedure difficult, so topical anesthesia is generally used prior the procedure. Objective: To analyze and compare the role of local anesthesia with placebo in flexible nasopharyngolaryngoscopy. Materials and Methodology: A prospective, longitudinal and analytical study conducted among 84 patients required flexible nasopharyngolaryngoscopy dividing in two groups of 4% xylocaine and normal saline spray each. The questionnaires about nasal pain, throat discomfort, bad taste, feeling of nausea and overall discomfort were filled up by using numeric rating scale. Data was analyzed using SPSS 11.5 software. Results: Regarding the nasal pain, throat pain, feeling of nausea and overall discomfort, they were statistically not significant in both groups. Whereas the bad taste score was less in normal saline spray group as compared to 4% xylocaine spray group showing statistically significant (p=0.000). Conclusion: Though we do use topical local anesthesia frequently for the flexible nasopharyngolaryngoscopy, there is no such extra benefit as compared to normal saline spray.References
[1] Jaumann MP, Steiner W. Endoscopy of the nose and nasopharynx. Endoscopy 1978; 10: 240-7. http://dx.doi.org/10.1055/s-0028-1098302
[2] Sunkaraneni VS, Jones SEM. Topical anesthetic or vasoconstrictor preparations for flexible fibre-optic nasal pharyngoscopy and laryngoscopy. Cochrane Database Sys Rev 2011; 3: CD005606. DOI;10.1002/14651858.CD005606. pub2.
[3] Singh V, Brockbank MJ, Todd GB. Flexible transnasal endoscopy: is local anesthesia really necessary? J Laryngol Otol 1997; 11: 616-18.
[4] Nankivell PC, Pothier DD. Nasal and instrument preparation prior to rigid and flexible naso endoscopy: a systematic review. JLO 2008; 122: 1024-28. http://dx.doi.org/10.1017/S0022215108002533
[5] Frosh AC, Jayaraj S, Porter G, Almeyda J. Is local anesthesia actually beneficial in flexible fibreoptic nasoendoscopy? Clin Otolaryngol Allied Sci 1998; 23: 259- 62. http://dx.doi.org/10.1046/j.1365-2273.1998.00149.x
[6] Leder SB, Ross DA, Briskin KB. A prospective, double-blind, randomized study on the use of anesthetic, vasoconstrictor, and placebo during transnasal flexible endoscopy. J Speech Lang Hear Res 1997; 40: 1352-57.
[7] Georgalas C, Sandhu G, Frosh A, Xenellis J. Cophenylcaine spray versus placebo in flexible nasoendoscopy: a prospective double-blind randomized controlled trial. Int J Clin Pract 2005; 59: 130-33. http://dx.doi.org/10.1111/j.1742-1241.2005.00476.x
[8] Cain AJ, Murray DP, Mc Clymont LG. The use of topical nasal anesthesia before flexible nasoendoscopy: a doubleblind randomized controlled trialcomparing cophenylcaine with placebo. Clin Otolaryngol Allied Sci 2002; 27: 485-88. http://dx.doi.org/10.1046/j.1365-2273.2002.00608.x
[9] De Freitas, Hanna BC, Hall SJ. Comparison of Cophenylcaine spray or Lidocaine/Epinephrine nasal packing for flexible laryngoscopy. Clinical Medicine Insights: Ear Nose and Throat 2010; 3: 5-10.
[10] Sadek SAA, De R, Scott A, White AP, Wilson PS, Carlin WV. The efficacy of topical anesthesia in flexible nasoendoscopy: a double blind randomized controlled trial. Clin Otolaryngol 2001; 26: 25-8. http://dx.doi.org/10.1046/j.1365-2273.2001.00400.x
