title: A comparison of cocaine and 'co-phenylcaine' local anaesthesia in flexible nasendoscopy.
abstract: Cocaine is widely used as a local anaesthetic in the nose. However, it is potentially toxic, a known drug of addiction, and its spray delivery devices can theoretically transfer infection. This two-part study investigates a less toxic alternative, 5% lidocaine and 0.5% phenylephrine ('co-phenylcaine') solution, presented in a disposable spray. In the first part, the efficacy of co-phenylcaine was assessed in 25 healthy volunteers. Serial acoustic rhinometry showed a significant, sustained nasal decongestion after co-phenylcaine administration. Visual analogue scale (VAS) scores in response to a painful nasal stimulus confirmed a significant anaesthetic effect. In the second part, co-phenylcaine was compared with 10% cocaine spray in a randomized double-blind trial in 74 patients undergoing out-patient transnasal fibrescopic laryngoscopy. VAS pain ratings and nasal inspiratory peak flow recordings showed no difference between the two solutions. No adverse effects were noted. It is concluded that co-phenylcaine is an excellent alternative to cocaine nasal spray.
authors.affiliation: Department of Pharmacy, Queens Hospital, Burton on Trent, Staffordshire, UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Smith
authors.forename: T J
authors.initials: TJ
authors.lastname: Rockley
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D003042:Cocaine / Q000008:administration & dosage; D004304:Dosage Forms; D004311:Double-Blind Method; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007828:Laryngoscopy; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D014663:Nasal Decongestants / Q000008:administration & dosage; D013517:Otorhinolaryngologic Surgical Procedures; D010656:Phenylephrine / Q000008:administration & dosage
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D004304:Dosage Forms; D014663:Nasal Decongestants; D010656:Phenylephrine; D008012:Lidocaine; D003042:Cocaine