title: [Topical anesthesia in flexible nasofibrolaryngoscopy].
abstract: BACKGROUND
  The emergence of flexible nasofibrolaryngoscopy in recent decades has facilitated the development of Otolaryngology and the nasofibrolaryngoscope has become an essential diagnostic tool for the otolaryngologist. However, its use is not without discomfort for the patient, which is why various options for topical anaesthesia have been proposed during the development of the technique.
  
  
  METHODS
  This was a prospective, double blind, crossover study in patients with no history of nasal disease, through which we compared the use of topical anaesthetic (Lidocaine) + epinephrine, oxymetazoline and placebo. Using a visual analogue scale, the degree of discomfort was assessed during each scan.
  
  
  RESULTS
  We evaluated 18 patients, 10 women (55.6%) and 8 men (44.4%), with a mean age of 28±4 years. The degree of disturbance generated by the scan with the application of lidocaine-epinephrine was 1.94; with oxymetazoline it was 3.78, and with placebo, 4.61. When the lidocaine-epinephrine solution was compared with oxymetazoline, there was a statistical significance in favour of lidocaine-epinephrine (P<0.05). When we compared the use of lidocaine-epinephrine with the placebo, the result was also statistically significant in favour of lidocaine-epinephrine (P<0.05).
  
  
  CONCLUSIONS
  In this study we demonstrated that using lidocaine associated with epinephrine as a topical anaesthetic prior to flexible nasofibrolaryngoscopy decreases pain and feeling of discomfort for the patient. Consequently, we can recommend the use of topical nasal anaesthesia when performing this exploration.
authors.affiliation: Servicio ORL, Complejo Hospitalario Universitario de Vigo, Vigo, España. Electronic address: chiesaestomba86@gmail.com.
authors.forename: Carlos Miguel
authors.initials: CM
authors.lastname: Chiesa Estomba
authors.affiliation: Servicio ORL, Complejo Hospitalario Universitario de Vigo, Vigo, España.
authors.forename: Carla Cristina
authors.initials: CC
authors.lastname: Ossa Echeverri
authors.affiliation: Servicio ORL, Complejo Hospitalario Universitario de Vigo, Vigo, España.
authors.forename: Ana Sofía
authors.initials: AS
authors.lastname: Araujo da Costa
authors.affiliation: Servicio ORL, Complejo Hospitalario Universitario de Vigo, Vigo, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rivera Schmitz
authors.affiliation: Servicio ORL, Complejo Hospitalario Universitario de Vigo, Vigo, España.
authors.forename: Pilar
authors.initials: P
authors.lastname: Castro Ruiz
authors.affiliation: Servicio ORL, Complejo Hospitalario Universitario de Vigo, Vigo, España.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Santidrián Hidalgo
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D004837:Epinephrine; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000009:adverse effects; D008012:Lidocaine; D008297:Male; D009666:Nose; D010109:Oxymetazoline; D011446:Prospective Studies
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D010109:Oxymetazoline; D008012:Lidocaine; D004837:Epinephrine
keywords: Anaesthetic; Anestesia; Flexible; Nasofibrolaringoscopia; Nasofibrolaryngoscopy; Topical; Tópica