title: Comparison of topical anesthetic effects of lidocaine, prilocaine, ropivacaine, and bupivacaine in transnasal fiberoptic nasopharyngolaryngoscopy.
abstract: BACKGROUND
  This study was designed to investigate the topical anesthetic efficacy of four different solutions including lidocaine spray, bupivacaine, ropivacaine, and prilocaine used in patients undergoing transnasal fiberoptic nasopharyngolaryngoscopic examination (TFL).
  
  
  METHODS
  The study included 200 patients who underwent anterior rhinoscopy and TFL examination as a part of routine otolaryngological evaluation in our outpatient clinics. Of these, 111 were female and 89 were male patients. The mean age of the patients was 32 ± 8 years (aged between 19 and 55 years). The patients were randomly divided into five groups. Five groups received one of the local anesthetics studied in our trial (10% lidocaine, 0.5% ropivacaine, 0.25% bupivacaine, 2% prilocaine, and saline solution) in each right side of the nose for 10 minutes before TFL. Each separate examination was performed on the right side of the nasal cavity. After the examination, the patients were asked to note the intensity of the pain that they have experienced during the TFL, by using a 100-mm visual analog scale (VAS).
  
  
  RESULTS
  The mean VAS scores were 2.08 (SD, 0.62) in the lidocaine group, 2.21 (SD, 0.66) in the prilocaine group, 3.92 (SD, 0.58) in the ropivacaine group, 4.15 (SD, 0.64) in the bupivacaine group, and 6.35 (SD, 0.65) in the saline solution group. The lidocaine and prilocaine groups had significantly better VAS scores versus ropivacaine, bupivacaine, and saline solution groups (p < 0.05).
  
  
  CONCLUSIONS
  To provide ideal examination comfort and optimum patient tolerability during TFL evaluation of upper respiratory airway topical lidocaine and prilocaine applications were found to be more efficacious and effective medication for anesthesia of the intranasal mucosa compared with bupivacaine and ropivacaine solutions.
authors: Department of Otolaryngology, Head and Neck Surgery, Bozok University Medical Faculty, Yozgat, Turkey.
authors: Mahmut
authors: M
authors: Özkiriş
authors: Reha
authors: R
authors: Aydin
authors: Zeliha Kapusuz
authors: ZK
authors: Gencer
authors: Levent
authors: L
authors: Saydam
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D000777:Anesthetics / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007828:Laryngoscopy; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000187:drug effects* / Q000601:surgery; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011318:Prilocaine / Q000008:administration & dosage* / Q000009:adverse effects; D000077212:Ropivacaine; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D000577:Amides; D000777:Anesthetics; D011318:Prilocaine; D000077212:Ropivacaine; D008012:Lidocaine; D002045:Bupivacaine