title: The physiologic impact of transnasal flexible endoscopy.
abstract: OBJECTIVE
  Diagnostic transnasal flexible endoscopy (TNFE) is a commonly used office procedure in otolaryngology. Currently there is a paucity of data on the impact of TNFE on physiologic parameters. This is relevant with the advent of office-based endoscopic procedures. The goal of this study is to measure the impact of topical decongestion, anesthesia, and diagnostic TNFE on vital signs: systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), and oxygenation (O(2)  sat).
  
  
  METHODS
  Prospective case control study, in which the patient is his/her control.
  
  
  METHODS
  Vital signs were obtained at baseline, immediately after the application of Neosynephrine, after the application of lidocaine, 5 minutes later, with the scope in the nasopharynx and hypopharynx, and upon completion of the procedure.
  
  
  RESULTS
  Compared to the baseline data, there was a statistically significant increase in HR after the procedure (mean change, 4.06 ± 10.15 bpm; range, -14 to 42 bpm, P = .01). There was also a change in O(2)  sat (mean change, 0.42% ± 1.36%; range -3% to 3%, P = .03) after the application of lidocaine. When comparing each data point to the preceding point, there was a statistically significant change in SBP with the scope in the nasopharynx (mean change, 5.34 ± 10.65 mm Hg; range, -22 to 28 mm Hg, P = .001) and in HR with the scope in the hypopharynx (mean change, 3.76 ± 6.41 bpm; range, -9 to 19 bpm, P = .0004).
  
  
  CONCLUSIONS
  Diagnostic TNFE and topical lidocaine can have an impact on physiologic parameters; however, these changes are unlikely to be clinically significant.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA. julinao@bcm.edu
authors.forename: Julina
authors.initials: J
authors.lastname: Ongkasuwan
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Yung
authors.forename: Mark S
authors.initials: MS
authors.lastname: Courey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods; D001795:Blood Pressure Determination / Q000379:methods; D016022:Case-Control Studies; D004724:Endoscopy / Q000379:methods; D004867:Equipment Design; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D055986:Vital Signs; D055815:Young Adult
chemical_list: D010100:Oxygen