'Moffett's' solution: a review of the evidence and scientific basis for the topical preparation of the nose.
General anaesthesia, often causes a widespread vasodilation, producing a hyperaemic nasal mucosa, hence the need for a topical application to decongest the nose and reduce the nasal blood flow to optimize the operative field. The use of a combination of cocaine, sodium bicarbonate and adrenaline given the eponymous title of 'Moffett's Solution' is standard practice in many rhinological procedures to provide local anaesthesia, vasoconstriction and decongestion. We discuss each component of 'Moffett's' reviewing the science and evidence behind its usage and the huge variation in the techniques of its application.
Benjamin
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Royal National Throat Nose and Ear Hospital, London, UK. elliot.benjamin@virgin.net
Wong
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Choa
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D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000494:pharmacology; D003042:Cocaine / Q000008:administration & dosage* / Q000494:pharmacology; D004837:Epinephrine / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D009296:Nasal Cavity / Q000098:blood supply / Q000187:drug effects*; D014663:Nasal Decongestants / Q000008:administration & dosage*; D019999:Pharmaceutical Solutions; D012225:Rhinoplasty; D017693:Sodium Bicarbonate / Q000008:administration & dosage* / Q000494:pharmacology; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D000779:Anesthetics, Local; D014663:Nasal Decongestants; D019999:Pharmaceutical Solutions; D014662:Vasoconstrictor Agents; D017693:Sodium Bicarbonate; D003042:Cocaine; D004837:Epinephrine