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The use of visual distraction to improve the tolerability of flexible laryngoscopy

Published online by Cambridge University Press:  19 July 2018

T C Biggs ,
A Henderson ,
F Shelton  and
N N Patel
T C Biggs*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, UK
A Henderson
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, UK
F Shelton
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, UK
N N Patel
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, UK
*
Author for correspondence: Mr Timothy Biggs, Department of Otolaryngology, Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK E-mail: t.biggs@soton.ac.uk
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Abstract

Background

Flexible laryngoscopy is a commonly performed procedure in otolaryngology. Although this procedure is not considered painful, many patients describe it as uncomfortable. This study investigated the role of visual distraction as a form of pain relief during flexible laryngoscopy.

Methods

The study included patients undergoing flexible laryngoscopy at the University Hospital Southampton. Patients were self-allocated to one of four groups: with or without co-phenylcaine anaesthetic spray; and with and without visual distraction. Visual distraction involved the patient watching the procedure concurrently with the clinician, via a video monitor. Pre- and post-procedural discomfort was assessed using a visual analogue scale.

Results

The use of topical anaesthetic spray was not associated with significantly reduced discomfort scores (p > 0.05). Discomfort scores were significantly reduced in the visual distraction groups (p = 0.04), irrespective of the use of topical anaesthetic spray.

Conclusion

This small study showed that visual distraction should be considered as a simple and cost-effective alternative to local anaesthetic for flexible laryngoscopy.

Keywords

LaryngoscopyOtolaryngologyPain
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 8 , August 2018 , pp. 739 - 741
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Mr T Biggs takes responsibility for the integrity of the content of the paper

References

1Holsinger, FC, Kies, MS, Weinstock, YE, Lewin, JS, Hajibashi, S, Nolen, DD et al. Videos in clinical medicine. Examination of the larynx and pharynx. N Engl J Med 2008;358:e2Google Scholar
2Leder, SB, Ross, DA, Briskin, KB, Sasaki, CT. A prospective, double-blind, randomized study on the use of a topical anesthetic, vasoconstrictor, and placebo during transnasal flexible fiberoptic endoscopy. J Speech Lang Hear Res 1997;40:1352–7Google Scholar
3Smith, JC, Rockley, TJ. A comparison of cocaine and ‘co-phenylcaine’ local anaesthesia in flexible nasendoscopy. Clin Otolaryngol Allied Sci 2002;27:192–6Google Scholar
4Pothier, DD, Awad, Z, Whitehouse, M, Porter, GC. The use of lubrication in flexible fibreoptic nasendoscopy: a randomized controlled trial. Clin Otolaryngol 2005;30:353–6Google Scholar
5Singh, V, Brockbank, MJ, Todd, GB. Flexible transnasal endoscopy: is local anaesthetic necessary? J Laryngol Otol 1997;111:616–18Google Scholar
6National Institute for Health and Care Excellence. Lidocaine with phenylephrine. In: https://bnf.nice.org.uk/drug/lidocaine-with-phenylephrine.html [26 January 2018]Google Scholar
7Johnson, 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 Scholar
8Choudhury, N, Amer, I, Daniels, M, Wareing, MJ. Audiovisual distraction reduces pain perception during aural microsuction. Ann R Coll Surg Engl 2013;95:34–6Google Scholar
9Lee, DW, Chan, AC, Wong, SK, Fung, TM, Li, AC, Chan, SK et al. Can visual distraction decrease the dose of patient-controlled sedation required during colonoscopy? A prospective randomized controlled trial. Endoscopy 2004;36:197–201Google Scholar
10Marsdin, E, Noble, JG, Reynard, JM, Turney, BW. Audiovisual distraction reduces pain perception during shockwave lithotripsy. J Endourol 2012;26:531–4Google Scholar