title: EMLA(®) cream as local anesthetic for radiofrequency turbinate tissue reduction.
abstract: Radiofrequency volumetric tissue reduction is a minimally invasive technique in the treatment of turbinate hypertrophy and is generally performed under local anesthesia. However, perioperative discomfort and pain are common side effects and studies concerning the technique of choice to anesthetize the nasal mucosa in this procedure are lacking. The aim of this prospective controlled trial is to assess the effectiveness of EMLA(®) cream as a topical anesthetic for radiofrequency volumetric tissue reduction of inferior turbinates comparing its effect with that obtained using a traditional anesthetic technique. 200 consecutive patients undergoing volumetric tissue reduction with topical anesthesia were enrolled. Patients were divided into two groups: Group A included 100 patients treated by placing cotton pledgets soaked with lidocaine 10% in the inferior meatus followed by the injection of 2% lidocaine into the head of the inferior turbinate; Group B included 100 patients treated with EMLA(®) cream. Patients were evaluated before and after surgery using rhinomanometry for obstructive symptoms. Four VAS about pain, troublesome swallowing, choking sensation and intraoperative anxiety were submitted to each patient immediately after surgery and after 2 months to assess various aspects of perioperative discomfort. A significant increase of nasal airflow was observed without differences between the two groups. Subjective evaluation regarding perioperative discomfort showed significant differences between Groups A and B immediately after surgery although it was less pronounced 2 months later. The results of this study suggest that EMLA(®) cream is an efficient tool in obtaining an adequate anesthetic effect in this procedure.
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, ENT Section, "Sapienza" University of Rome, Latina (LT), Italy, salvomartello@live.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Martellucci
authors.forename: Giulio
authors.initials: G
authors.lastname: Pagliuca
authors.forename: Marco
authors.initials: M
authors.lastname: de Vincentiis
authors.forename: Antonio
authors.initials: A
authors.lastname: Greco
authors.forename: Massimo
authors.initials: M
authors.lastname: Fusconi
authors.forename: Armando
authors.initials: A
authors.lastname: De Virgilio
authors.forename: Chiara
authors.initials: C
authors.lastname: Rosato
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001847:Bone Diseases / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D009824:Ointments; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011318:Prilocaine / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome; D014420:Turbinates / Q000601:surgery*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine