Chiesa Estomba Carlos Miguel, Ossa Echeverri Carla Cristina, Araujo da Costa Ana Sofía, Rivera Schmitz Teresa, Castro Ruiz Pilar, Santidrián Hidalgo Carmelo
Servicio ORL, Complejo Hospitalario Universitario de Vigo, Vigo, España.
Servicio ORL, Complejo Hospitalario Universitario de Vigo, Vigo, España.
Acta Otorrinolaringol Esp. 2015 Mar-Apr;66(2):83-6. doi: 10.1016/j.otorri.2014.03.009. Epub 2014 Jul 18.
The emergence of flexible nasofibrolaryngoscopy in recent decades has facilitated the development of Otolaryngology and the nasofibrolaryngoscope has become an essential diagnostic tool for the otolaryngologist. However, its use is not without discomfort for the patient, which is why various options for topical anaesthesia have been proposed during the development of the technique.
This was a prospective, double blind, crossover study in patients with no history of nasal disease, through which we compared the use of topical anaesthetic (Lidocaine) + epinephrine, oxymetazoline and placebo. Using a visual analogue scale, the degree of discomfort was assessed during each scan.
We evaluated 18 patients, 10 women (55.6%) and 8 men (44.4%), with a mean age of 28±4 years. The degree of disturbance generated by the scan with the application of lidocaine-epinephrine was 1.94; with oxymetazoline it was 3.78, and with placebo, 4.61. When the lidocaine-epinephrine solution was compared with oxymetazoline, there was a statistical significance in favour of lidocaine-epinephrine (P<0.05). When we compared the use of lidocaine-epinephrine with the placebo, the result was also statistically significant in favour of lidocaine-epinephrine (P<0.05).
In this study we demonstrated that using lidocaine associated with epinephrine as a topical anaesthetic prior to flexible nasofibrolaryngoscopy decreases pain and feeling of discomfort for the patient. Consequently, we can recommend the use of topical nasal anaesthesia when performing this exploration.
近几十年来，可弯曲鼻咽喉镜的出现推动了耳鼻喉科学的发展，鼻咽喉镜已成为耳鼻喉科医生必不可少的诊断工具。然而，其使用会给患者带来不适，这就是为什么在该技术发展过程中提出了各种局部麻醉的选择。
这是一项针对无鼻部疾病史患者的前瞻性、双盲、交叉研究，我们比较了局部麻醉剂（利多卡因）+肾上腺素、羟甲唑啉和安慰剂的使用情况。使用视觉模拟量表，在每次检查过程中评估不适程度。
我们评估了18例患者，其中10例女性（55.6%），8例男性（44.4%），平均年龄28±4岁。应用利多卡因-肾上腺素进行检查所产生的干扰程度为1.94；应用羟甲唑啉时为3.78，应用安慰剂时为4.61。将利多卡因-肾上腺素溶液与羟甲唑啉进行比较时，利多卡因-肾上腺素具有统计学意义（P<0.05）。当我们将利多卡因-肾上腺素的使用与安慰剂进行比较时，结果同样具有统计学意义，支持利多卡因-肾上腺素（P<0.05）。
在本研究中，我们证明在可弯曲鼻咽喉镜检查前使用利多卡因联合肾上腺素作为局部麻醉剂可减轻患者的疼痛和不适感。因此，我们建议在进行此项检查时使用局部鼻麻醉。
