Comparative study between Efficacy of 0.025% Oxymetazoline with 1% Lidocaine and 1% Ephedrine with 2% Lidocaine in Nasal Preparation before Nasal Endoscopy
Keywords:Nasal endoscopy, Nasal packing, Ephedrine, Oxymetazoline, Lidocaine
Background: Nasal endoscopy is a common and valuable procedure in rhinologic examination. Preparation for nasal endoscopy is usually applied decongestant and/or local anesthetic agents into nostrils to relieve pain and enhance visualization during endoscopy. This study aimed to conduct a comparative study between efficacy of 0.025% oxymetazoline with 1% lidocaine and 1% ephedrine with 2% lidocaine in nasal preparation before nasal endoscopy. Methods: A prospective double-blinded randomized controlled trial was conducted in 60 patients aged between 18-70 years undergoing rigid nasal endoscopy at Bangpli Hospital. Nasal cavities of each patient were randomized to apply the cottonoid soaked with the mixture of 0.025% oxymetazoline with 1% lidocaine or 1% ephedrine with 2% lidocaine before nasal endoscopic procedure. Outcomes were assessed for nasal congestion level, pain during packing, pain during endoscopy, clarity of endoscopic view and visualization of nasal anatomical structures. Results: Both 0.025% oxymetazoline with 1% lidocaine and 1% ephedrine with 2% lidocaine were able to reduce the nasal congestion (3.57±2.91 VS 1.52±2.14, p-value = 0.000) and (3.48±2.46 VS 1.34±1.81, p-value = 0.000) respectively. There was no statistically significant difference between two groups in all outcomes. Difference of pre- and post-packing nasal congestion level (2.05±2.47 VS 2.14±2.19, p-value = 0.890), pain during packing (1.96±2.30 VS 1.77±2.37, p-value = 0.060), pain during endoscopy (4.19±3.36 VS 4.05±3.35, p-value = 0.359), clarity of endoscopic view (6.71±2.24 VS 6.98±2.39, p-value = 0.204) and visualization of nasal anatomical structures (3.78±0.74 VS 3.90±0.78, p-value = 0.106). Conclusion: The efficacy of 0.025% oxymetazoline with 1% lidocaine was not different from 1% ephedrine with 2% lidocaine. Both mixtures can be used in nasal preparation before nasal endoscopy.
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