Comparison of lidocaine and levobupivacaine in transnasal fiberoptic laryngoscopy.
BACKGROUND
The anatomy of the nasal passages, pharynx, and larynx and evaluation of mucous membranes and laryngeal function is well observed by transnasal fiberoptic laryngoscopy (TFL). In this procedure, to provide good local infiltrative analgesia, medication such as anesthetics is important for the otolaryngologist. The aim of this study was to evaluate the efficacy of lidocaine (L) spray, compared with levobupivacaine solution, used for local anesthetic in patients undergoing TFL for complete examination.


METHODS
Sixty-two subjects (39 men and 23 women; mean age, 36 ± 7 years) were enrolled in the study. Patients were randomly classified into two groups as levobupivacaine hydroclorur (LB) and L groups. A standard flexible transnasal fiberoptic 4.2-mm-diameter laryngoscope was passed through the nasal cavity and into the aerodigestive tract. Patients were asked to evaluate the intensity of the pain they experienced during the TFL, using a visual analog scale (VAS) and Ramsay sedation scale.


RESULTS
Demographic data were similar in both groups. There was no difference in VAS and Ramsay scores between both groups (p > 0.05).


CONCLUSIONS
Our findings indicated that topical levobupivacaine seems to be an effective medication for anesthesia of the nasal mucosa and may be used to allow complete examinations involving TFL.
Department of Otorhinolaryngology, Izzet Baysal Medicine Faculty of Abant Izzet Baysal University, Bolu, Turkey. tayfunent@yahoo.com
Tayfun
T
Apuhan
Hasan
H
Kocoglu
Nebahat
N
Gulcu
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D000077554:Levobupivacaine; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D059085:Nasal Sprays; D055100:Optical Fibers / Q000706:statistics & numerical data; D010147:Pain Measurement; D016896:Treatment Outcome
D000779:Anesthetics, Local; D059085:Nasal Sprays; D008012:Lidocaine; D000077554:Levobupivacaine; D002045:Bupivacaine