Hwang Se Hwan, Park Chan-Soon, Kim Byung Guk, Cho Jin Hee, Kang Jun Myung
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Bucheon St. Mary`s Hospital, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon-city, Gyeonggi-do, 420-717, Republic of Korea.
Eur Arch Otorhinolaryngol. 2015 Feb;272(2):263-70. doi: 10.1007/s00405-014-3012-8. Epub 2014 Mar 29.
Transnasal endoscopy can cause pain or discomfort for the patient. Topical anesthetic has been used in an attempt to reduce this. However, there is no consensus on whether topical anesthetic is effective in optimizing patient experience during the procedure. The goal of this study was to perform a systematic review with meta-analysis of the efficacy of topical anesthetic on pain and comfort outcomes during endoscopy. Two authors independently searched the databases from inception to September 2013. Studies comparing topical anesthetic with placebo where the outcomes of interest were pain, comfort, or side effect outcomes were included. Sufficient data for meta-analysis were retrieved for ten trials with a total of 837 patients. The evidence suggests that local anesthetic alone or in combination with a vasoconstrictor is beneficial to patients' pain [standardized mean difference (SMD) = -0.21; p = 0.045] and comfort (SMD = -0.51; p < 0.001) outcomes when performing transnasal endoscopy. However, the topical anesthetic caused unpleasant sensation with respect to an unpleasant taste (SMD = 0.77; p < 0.001). In addition, there was no significant difference between a topical anesthetic spray and cotton type in pain and discomfort values. Applying topical anesthetic during transnasal endoscopy could reduce pain and discomfort. The spray and cotton type methods of topical anesthetic preparation showed no significant difference in terms of pain and discomfort during the procedure. However, further trials with good research methodology should be conducted to confirm our results.
经鼻内镜检查会给患者带来疼痛或不适。人们尝试使用局部麻醉剂来减轻这种情况。然而，对于局部麻醉剂在优化检查过程中患者体验方面是否有效，目前尚无共识。本研究的目的是对局部麻醉剂在内镜检查期间对疼痛和舒适度结果的疗效进行系统评价和荟萃分析。两位作者独立检索了从数据库建立到2013年9月的文献。纳入了比较局部麻醉剂与安慰剂的研究，这些研究的关注结果为疼痛、舒适度或副作用结果。共检索到十项试验的足够数据用于荟萃分析，涉及837名患者。证据表明，单独使用局部麻醉剂或与血管收缩剂联合使用，在进行经鼻内镜检查时，对患者的疼痛（标准化均数差[SMD]= -0.21；p = 0.045）和舒适度（SMD = -0.51；p < 0.001）结果有益。然而，局部麻醉剂会引起令人不适的味觉（SMD = 0.77；p < 0.001）。此外，局部麻醉喷雾和棉片在疼痛和不适值方面没有显著差异。在经鼻内镜检查期间应用局部麻醉剂可减轻疼痛和不适。局部麻醉剂的喷雾和棉片制备方法在检查过程中的疼痛和不适方面没有显著差异。然而，应该进行更多方法良好的试验来证实我们的结果。
