title: Premedication Methods in Nasal Endoscopy: A Prospective, Randomized, Double-Blind Study.
abstract: OBJECTIVE
  To identify the optimal pharmacological method of preparing patients for nasal endoscopy.
  
  
  METHODS
  Twenty healthy volunteers were enrolled in this prospective, randomized, double-blind study. Four types of medications were applied in their nostrils with binary combinations of spray bottles on four different days in a random order: placebo (normal saline [NS]+NS), decongestant (NS+oxymetazoline), anesthetic (NS+lidocaine), and decongestant plus anesthetic (oxymetazoline+lidocaine). Rigid nasal endoscopy was performed 10 minutes after spray application. The volunteers evaluated the discomfort caused by each spray application, and nasal pain scores due to the passage of the endoscope. The physicians quantified nasal decongestion using a visual analogue scale. Endoscopy duration as well as pulse and mean blood pressure (MBP) before spray application, 10 minutes after the application, and immediately after endoscopic examination were also recorded.
  
  
  RESULTS
  The discomfort caused by lidocaine was significantly higher than that caused by the other sprays (P<0.001). The lowest pain score related to endoscopy was obtained for oxymetazoline+lidocaine (P<0.001). Nasal decongestion was best achieved with NS+oxymetazoline (P<0.001). Endoscopy duration was the shortest for oxymetazoline+ lidocaine (P<0.05). Statistically significant MBP changes were only seen with the application of NS+oxymetazoline (P<0.05). However, neither MBP nor pulse rate change was significant clinically.
  
  
  CONCLUSIONS
  Application of decongestant and anesthetic sprays together seems to be the best method of pharmacological preparation of patients for nasal endoscopy.
authors.affiliation: Department of Otolaryngology, Erciyes University Medical School, Kayseri, Turkey.
authors.forename: Mehmet İlhan
authors.initials: Mİ
authors.lastname: Şahin
authors.affiliation: Department of Otolaryngology, Erciyes University Medical School, Kayseri, Turkey.
authors.forename: Kerem
authors.initials: K
authors.lastname: Kökoğlu
authors.affiliation: Department of Otolaryngology, Akdağmadeni State Hospital, Yozgat, Turkey.
authors.forename: Şafak
authors.initials: Ş
authors.lastname: Güleç
authors.affiliation: Department of Otolaryngology, Erciyes University Medical School, Kayseri, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Ketenci
authors.affiliation: Department of Otolaryngology, Erciyes University Medical School, Kayseri, Turkey.
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Ünlü
keywords: Anesthetics; Endoscopy; Lidocaine; Nasal Decongestants; Oxymetazoline