Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-24T22:59:45.867Z Has data issue: false hasContentIssue false
  • English
  • Français

Cross-over study of topical anaesthesia with tetracaine solution for transoral rigid laryngoscopy

Published online by Cambridge University Press:  11 September 2012

Z-H Zhu ,
J Zheng ,
L-Y Ying ,
B-W Zhu ,
J Qian  and
Z-X Ma
Z-H Zhu
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
J Zheng
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
L-Y Ying
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
B-W Zhu
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
J Qian
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
Z-X Ma*
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
*
Address for correspondence: Dr ZhaoXin Ma, Department of Otolaryngology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China Fax: +86 21 58763830 E-mail: mzhx114@163.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Transoral rigid laryngoscopy with videostroboscopy is the most practical method to visualise the vocal folds. The optimal topical anaesthesia regimen for transoral rigid laryngoscopy has not yet been established.

Objective:

To compare patient comfort and compliance with various topical anaesthetics for transoral rigid laryngoscopy.

Methods:

Each of 10 patients received a random topical administration of either 2 per cent lidocaine gel, 1 per cent tetracaine gel or 1 per cent tetracaine solution, 10 minutes before undergoing rigid laryngoscopy with videostroboscopy. During follow-up laryngoscopies, the agent with the lowest mean visual analogue scale score for discomfort was then used to study the timing of topical anaesthetic application: the agent was given to the patient 5, 10 or 15 minutes before laryngoscopy (with the timing randomly selected).

Results:

Compared with lidocaine gel or tetracaine gel, laryngoscopy with topical tetracaine solution was more comfortable. There was a statistically significant difference in discomfort score between the 5 and 10 minute application groups, but not between the 10 and 15 minute groups.

Conclusion:

Tetracaine solution, applied topically 10 minutes before transoral rigid laryngoscopy, significantly decreases patient discomfort.

Keywords

LaryngoscopyAnesthesia, LocalTetracaine
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 11 , November 2012 , pp. 1150 - 1154
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Moorthy, SS, Gupta, S, Laurent, B, Weisberger, EC. Management of airway in patients with laryngeal tumors. J Clin Anesth 2005;17:604–9CrossRefGoogle ScholarPubMed
2 Sulica, L, Blitzer, A. Anesthesia for laryngeal surgery in the office. Laryngoscope 2000;110:1777–9CrossRefGoogle ScholarPubMed
3 Cheung, J, Goodman, K, Bailey, R, Fedorak, R, Morse, J, Millan, M et al. A randomized trial of topical anesthesia comparing lidocaine versus lidocaine plus xylometazoline for unsedated transnasal upper gastrointestinal endoscopy. Can J Gastroenterol 2010;24:317–21CrossRefGoogle ScholarPubMed
4 Johnson, PE, Belafsky, PC, Postma, GN. Topical nasal anesthesia for transnasal fiberoptic laryngoscopy: a prospective, double-blind, cross-over study. Otolaryngol Head Neck Surg 2003;128:452–4Google ScholarPubMed
5 Jacobs, MA, Kenny, DT. Effects of topical anesthetic and flexible fiberoptic laryngoscopy on professional sopranos. J Voice 2005;19:645–64CrossRefGoogle ScholarPubMed
6 Singh, V, Brockbank, MJ, Todd, GB. Flexible transnasal endoscopy: is local anaesthetic necessary? J Laryngol Otol 1997;111:616–18CrossRefGoogle ScholarPubMed
7 Simpson, CB, Amin, MR, Postma, GN. Topical anesthesia of the airway and esophagus. Ear Nose Throat J 2004;83:2–5 Google ScholarPubMed
8 Ma, ZX, Zhu, ZH, Wang, JC. Syphilis of larynx–chancre epiglottis [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011;46:598–9Google ScholarPubMed
9 Stolz, D, Chhajed, PN, Leuppi, J, Pflimlin, E, Tamm, M. Nebulized lidocaine for flexible bronchoscopy: a randomized, double-blind, placebo-controlled trial. Chest 2005;128:1756–60CrossRefGoogle ScholarPubMed
10 Scharfe, EE. Anaesthesia for peroral endoscopy. Can Med Assoc J 1951;65:134–8Google ScholarPubMed
11 Christoforidis, AJ, Tomashefski, JF, Mitchell, RI. Use of an ultrasonic nebulizer for the application of oropharyngeal, laryngeal and tracheobronchial anesthesia. Chest 1971;59:629–33CrossRefGoogle ScholarPubMed
12 Jonas, NE, Visser, MF, Oomen, A, Albertyn, R, van Dijk, M, Prescott, CA. Is topical local anaesthesia necessary when performing paediatric flexible nasendoscopy? A double-blind randomized controlled trial. Int J Pediatr Otorhinolaryngol 2007;71:1687–92CrossRefGoogle ScholarPubMed
13 Festic, E, Johnson, MM, Leventhal, JP. The feasibility of topical cocaine use in fiberoptic bronchoscopy. Acta Med Acad 2010;39:1–6 Google Scholar
14 British Thoracic Society Bronchoscopy Guidelines Committee. British Thoracic Society guidelines on diagnostic flexible bronchoscopy. Thorax 2001;56(suppl 1):i1–21CrossRefGoogle Scholar