Department of Otolaryngology - Head and Neck Surgery, The University of Ottawa, Ottawa, ON, Canada.
Clin Otolaryngol. 2011 Dec;36(6):550-7. doi: 10.1111/j.1749-4486.2011.02403.x.
To test the hypothesis that using lidocaine nasal spray will result in improved pain and comfort outcomes during an extended flexible endoscopic nasal examination.
A split-body, double-blind, placebo-controlled randomised trial. After receiving a rinse of oral mouthwash (Listerine(®)), patients were randomised to receive placebo in one nasal cavity and 30 mg of topical lidocaine in the other.
A tertiary care centre outpatient Otolaryngology clinic.
Twenty-two patients who required an extended bilateral flexible endoscopic nasal examination. An extended nasal examination consisted of an examination of a minimum of two osteomeatal regions on each side of the nasal cavity.
Discomfort and pain were assessed using a 100-mm Visual Analogue Scale (VAS). Our study utilised the definition of pain based on International Association for the Study of Pain. Pain was defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Discomfort was defined as the overall unpleasant experience of the procedure. This included all aspects of the examination such as the pain or other negative sensations associated with the examination, any side effects associated with the application of the nasal sprays as well as any anxiety associated with the examination. A Wilcoxon sign-rank test was used for the primary outcome measures.
There was a significant reduction in discomfort scores on the treatment side of the nasal cavity compared with the control side (median VAS score of 18.6 mm versus 44.6 mm; P = 0.01). The change in pain between the treatment side compared with the control side did not reach our definition of statistical significance (5.1 mm versus 9.2 mm; P = 0.05). Patients with an active or uncontrolled inflammatory disorder of the nasal cavity experienced a significantly greater reduction in pain compared to those without an inflammatory condition (median change of the VAS score, -15.6 versus +1.0; P = 0.01).
After a rinse with oral mouthwash, the use of lidocaine results in a significant reduction in the discomfort associated with an extended bilateral flexible endoscopic nasal examination. Patients undergoing such an examination would benefit from the application of lidocaine after masking the negative flavour using oral mouthwash.
检验假设，即在进行延长的软性内镜鼻腔检查时，使用利多卡因鼻喷雾剂将改善疼痛和舒适度。
分体式，双盲，安慰剂对照随机试验。在接受漱口（李斯德林®）后，患者被随机分配到一侧鼻腔接受安慰剂，另一侧鼻腔接受 30 毫克的局部利多卡因。
三级保健中心门诊耳鼻喉科诊所。
22 名需要进行双侧延长软性内镜鼻腔检查的患者。延长的鼻腔检查包括对鼻腔两侧至少两个额窦区域进行检查。
使用 100 毫米视觉模拟量表（VAS）评估不适和疼痛。我们的研究使用国际疼痛研究协会定义的疼痛。疼痛定义为与实际或潜在组织损伤相关的不愉快感觉和情感体验。不适定义为整个程序的不愉快体验。这包括检查的所有方面，如与检查相关的疼痛或其他负面感觉、鼻喷雾剂应用相关的任何副作用以及与检查相关的任何焦虑。主要观察指标采用 Wilcoxon 符号秩检验。
鼻腔治疗侧的不适评分与对照侧相比显著降低（VAS 评分中位数为 18.6 毫米比 44.6 毫米；P = 0.01）。治疗侧与对照侧的疼痛变化未达到统计学意义（5.1 毫米比 9.2 毫米；P = 0.05）。与无炎症的患者相比，鼻腔有活动性或未控制的炎症性疾病的患者疼痛缓解程度显著降低（VAS 评分中位数变化，-15.6 比 +1.0；P = 0.01）。
在使用口腔漱口水冲洗后，利多卡因的使用可显著降低延长双侧软性内镜鼻腔检查引起的不适。在掩盖了负面味道后，接受此类检查的患者将受益于利多卡因的应用。
