title: Cross-over study of topical anaesthesia with tetracaine solution for transoral rigid laryngoscopy.
abstract: BACKGROUND
  Transoral rigid laryngoscopy with videostroboscopy is the most practical method to visualise the vocal folds. The optimal topical anaesthesia regimen for transoral rigid laryngoscopy has not yet been established.
  
  
  OBJECTIVE
  To compare patient comfort and compliance with various topical anaesthetics for transoral rigid laryngoscopy.
  
  
  METHODS
  Each of 10 patients received a random topical administration of either 2 per cent lidocaine gel, 1 per cent tetracaine gel or 1 per cent tetracaine solution, 10 minutes before undergoing rigid laryngoscopy with videostroboscopy. During follow-up laryngoscopies, the agent with the lowest mean visual analogue scale score for discomfort was then used to study the timing of topical anaesthetic application: the agent was given to the patient 5, 10 or 15 minutes before laryngoscopy (with the timing randomly selected).
  
  
  RESULTS
  Compared with lidocaine gel or tetracaine gel, laryngoscopy with topical tetracaine solution was more comfortable. There was a statistically significant difference in discomfort score between the 5 and 10 minute application groups, but not between the 10 and 15 minute groups.
  
  
  CONCLUSIONS
  Tetracaine solution, applied topically 10 minutes before transoral rigid laryngoscopy, significantly decreases patient discomfort.
authors.affiliation: Department of Otolaryngology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Z-H
authors.initials: ZH
authors.lastname: Zhu
authors.forename: J
authors.initials: J
authors.lastname: Zheng
authors.forename: L-Y
authors.initials: LY
authors.lastname: Ying
authors.forename: B-W
authors.initials: BW
authors.lastname: Zhu
authors.forename: J
authors.initials: J
authors.lastname: Qian
authors.forename: Z-X
authors.initials: ZX
authors.lastname: Ma
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000188:drug therapy / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D010349:Patient Compliance; D011446:Prospective Studies; D013748:Tetracaine / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D013748:Tetracaine; D008012:Lidocaine