title: A randomised controlled trial assessing the efficacy of co-phenylcaine nasal spray in flexible transnasal pharyngolaryngoscopy.
abstract: INTRODUCTION The aim of this study was to assess whether using co-phenylcaine nasal spray before flexible transnasal pharyngolaryngoscopy results in reduced pain and discomfort during the procedure. METHODS This was a randomised controlled trial. Eighty-four patients were randomised to receive either co-phenylcaine nasal spray or placebo nasal spray before performing transnasal flexible pharyngolaryngoscopy. Patient reported outcome measures included pain, discomfort, unpleasantness and willingness to repeat the procedure while clinician reported outcome measures comprised ease of examination and quality of view obtained during the procedure. RESULTS There was no statistically significant difference in scores for pain, discomfort, unpleasantness and willingness to repeat the procedure between the co-phenylcaine and placebo groups. On the other hand, ease of examination scores were significantly better for the co-phenylcaine group than for the placebo group. CONCLUSIONS The majority of patients do not find flexible pharyngolaryngoscopy unpleasant or painful with or without topical nasal anaesthesia. However, the spray does appear to help the examiner in completing a satisfactory assessment.
authors.affiliation: University Hospitals Bristol NHS Foundation Trust , UK.
authors.forename: F
authors.initials: F
authors.lastname: Javed
authors.affiliation: Royal United Hospitals Bath NHS Foundation Trust , UK.
authors.forename: A
authors.initials: A
authors.lastname: Parmar
authors.affiliation: Gloucestershire Hospitals NHS Foundation Trust , UK.
authors.forename: A
authors.initials: A
authors.lastname: Hussain
authors.affiliation: University Hospitals Bristol NHS Foundation Trust , UK.
authors.forename: D
authors.initials: D
authors.lastname: Hajioff
authors.affiliation: Royal United Hospitals Bath NHS Foundation Trust , UK.
authors.forename: D
authors.initials: D
authors.lastname: Pinder
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D014663:Nasal Decongestants / Q000627:therapeutic use*; D059085:Nasal Sprays; D057605:Natural Orifice Endoscopic Surgery; D010146:Pain / Q000517:prevention & control*; D010656:Phenylephrine / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D014663:Nasal Decongestants; D059085:Nasal Sprays; C546419:phenylephrine, lidocaine drug combination; D010656:Phenylephrine; D008012:Lidocaine
keywords: Endoscopy; Nasal cavity; Randomised controlled trial; Topical anaesthesia