The use of lubrication in flexible fibreoptic nasendoscopy: a randomized controlled trial.
OBJECTIVE
To determine how lubrication of the endoscope prior to flexible fibreoptic nasendoscopy affects levels of patient discomfort and pain during endoscopy. To assess the extent to which lubrication affects the ease of nasendoscopy and the quality of the image obtained.


METHODS
Single blind, randomized controlled trial.


METHODS
Outpatient clinic of the Department of Otolaryngology at a secondary level referral centre.


METHODS
A total of 150 participants selected sequentially from patients requiring a nasendoscopy where the endoscope would be passed far enough to view the larynx. Patients requiring topical anaesthetic were excluded. All participants who were entered in the study completed the study. Endoscopy was performed by all grades of medical staff.


METHODS
Levels of discomfort and pain experienced by the participants were assessed by a visual analogue scale (VAS). Difficulty of passing the scope was indicated by the endoscopist using a VAS, as was the quality of image obtained.


RESULTS
There was no significant difference between mean scores for pain or discomfort of the lubricated and unlubricated groups (P = 0.46 and P = 0.82 respectively). Scores for difficulty of passing the scope were significantly lower in the lubricant group (P = 0.003) but loss of image was significantly greater (P = 0.008).


CONCLUSIONS
Lubrication of the endoscope prior to nasendoscopy does not reduce levels of discomfort or pain for the patient, but increases ease in insertion for the operator. However, this may be at the expense of reduced image quality.
Pothier
D D
DD
Department of Otolaryngology, St Michael's Hospital, Bristol, UK. email@davepothier.com
Awad
Z
Z
Whitehouse
M
M
Porter
G C
GC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002482:Cellulose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004724:Endoscopy / Q000379:methods* / Q000592:standards; D005260:Female; D005336:Fiber Optic Technology; D005990:Glycerol / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008153:Lubrication; D008297:Male; D008875:Middle Aged; D009666:Nose; D010146:Pain; D010710:Phosphates / Q000008:administration & dosage* / Q000009:adverse effects; D011409:Propylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D016037:Single-Blind Method
C042973:K-Y jelly; D010710:Phosphates; D011409:Propylene Glycols; D002482:Cellulose; D005990:Glycerol