TOPICAL ANAESTHESIA OF THE NASAL MUCOSA FOR FIBREOPTIC AIRWAY ENDOSCOPY

We have compared four methods of topical anaesthesia of the nostril for fibreoptic airway endoscopy in a randomized study with 31 unpre-medicated volunteers, each serving as his or her own control. Lignocaine spray, EMLA cream, three cotton swabs soaked in 4% lignocaine solution, or 2 % lignocaine g...

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 1992-02, Vol.68 (2), p.164-167
Main Authors: RANDELL, T., YLI-HANKALA, A., VALLI, H., LINDGREN, L.
Format: Article
Language:English
Subjects:
Administration, Topical
Adult
Airway: fibreoptic endoscopy
Anaesthetic techniques: topical
Anaesthetics
Anesthesia, Local - methods
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
Blood Pressure - drug effects
Bronchoscopy
Drug Combinations
Female
Fiber Optic Technology
Humans
Lidocaine
Lidocaine, Prilocaine Drug Combination
local: lignocaine
Male
Medical sciences
Middle Aged
Nasal Mucosa
Neuropharmacology
Patient Acceptance of Health Care
Pharmacology. Drug treatments
Prilocaine
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Summary:We have compared four methods of topical anaesthesia of the nostril for fibreoptic airway endoscopy in a randomized study with 31 unpre-medicated volunteers, each serving as his or her own control. Lignocaine spray, EMLA cream, three cotton swabs soaked in 4% lignocaine solution, or 2 % lignocaine gel was applied in a nostril for 3 min. Application of lignocaine spray was rated as the most unpleasant and EMLA cream the least unpleasant. Spray and gel caused an increase in arterial pressure. Anaesthesia of the mucosa, tested by passing a bronchoscope through the nose to the oropharynx was best with lignocaine spray or gel. Gel or EMLA, but not the local anaesthetic applied with swabs, obscured vision. When slight obscurity of vision is not a problem, local anaesthetic gel is recommended for anaesthesia of the nasal mucosa. Premedication or sedation is recommended for all the methods described here.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/68.2.164