title: Cocaine, lidocaine, tetracaine: which is best for topical nasal anesthesia?
abstract: The quality of nasal anesthesia obtained with three local anesthetic solutions (4% cocaine, 2% lidocaine in oxymetazoline, and 1% tetracaine in oxymetazoline) was evaluated in a randomized study. Each local anesthetic mixture was applied to the nasal septum of healthy volunteers using medication-soaked pledgets. Measurements of anesthetic effect (sensation threshold and pain perception) were made with Semmes-Weinstein monofilaments. Measurements were performed prior to local anesthetic application and 10 and 70 min after local anesthetic application. Subjects had greater increases in sensation threshold with tetracaine than with lidocaine or cocaine at both 10 and 70 min (P < 0.05). Subjects had greater decreases in pain perception with tetracaine than with lidocaine or cocaine at both time intervals (P < 0.05). Tetracaine mixed with oxymetazoline appears to be a superior topical anesthetic for nasal procedures.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center, San Antonio 78284-7838, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Noorily
authors.forename: S H
authors.initials: SH
authors.lastname: Noorily
authors.forename: R A
authors.initials: RA
authors.lastname: Otto
mesh_terms: D000328:Adult; D000772:Anesthesia, Local; D000779:Anesthetics, Local; D003042:Cocaine; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009666:Nose; D010147:Pain Measurement; D017288:Pain Threshold; D013748:Tetracaine
chemical_list: D000779:Anesthetics, Local; D013748:Tetracaine; D008012:Lidocaine; D003042:Cocaine